脑微出血MR影像、其与出血性转化的研究

发布时间：2018-07-26 11:24

【摘要】：目的:探讨磁敏感加权成像技术(SWI)对脑梗死合并脑微出血的诊断能力及微出血的临床应用价值。方法:分析2015年1月到2016年12月我院收治的脑梗死患者87例完整的临床资料,并行常规磁共振成像及SWI序列检查,并根据是否发生微出血(CMBs)分为以下两组:CMBs组(A组48例),非CMBs组(B组39例)。统计分析患者CMBs病灶数目、病灶分布范围,观察比较两组患者的有关危险因素。根据是否出现出血性转化(HT)分为HT组(C组15例)和非HT组(D组72例),观察比较分析两组的危险因素。结果:在脑微出血患者中,SWI序列检出微出血病灶947个,检出率可达100%;MRI T1WI序列检出微出血病灶134个,检出率为14.1%;MRI T2WI序列检出微出血病灶152个,检出率为16.1%;FLAIR序列检出微出血病灶159个,检出率为16.8%;SWI与其余3种方法相比,对脑微出血病灶检出率具有优势,且差异具有统计学意义(P0.05)。A、B两组患者在高血压级别、收缩压、舒张压、腔梗级别、脑白质变性级别方面进行比较,差异均具有统计学意义。C、D两组在微出血、脑梗死面积方面差异具有统计学意义(P0.05)。结论:SWI能敏感的检测CMBs病灶,CMBs可能增加HT的风险,对于脑梗死患者治疗、转归及预后等方面具有重要的临床应用价值。
[Abstract]:Objective: to evaluate the value of magnetic sensitivity weighted imaging (SWI) in the diagnosis of cerebral infarction complicated with microhemorrhage. Methods: 87 patients with cerebral infarction admitted to our hospital from January 2015 to December 2016 were analyzed. Routine magnetic resonance imaging and SWI sequence were performed. According to the occurrence of microhemorrhage, (CMBs) was divided into two groups: group A (n = 48) and group B (n = 39). The number and distribution of CMBs lesions were statistically analyzed and the relative risk factors were observed and compared between the two groups. According to whether hemorrhagic transformation occurred, (HT) was divided into HT group (group C, n = 15) and non-HT group (group D, n = 72). The risk factors of these two groups were compared and analyzed. Results: in the patients with intracerebral microhemorrhage, 947 microhaemorrhage lesions were detected by T1WI sequence, and the detectable rate was up to 134 by T1WI sequence, and the detectable rate was 14.1MRI T2WI sequence to detect 152 microhemorrhage lesions. The detection rate was 16.1% flair sequence to detect 159 microhemorrhage lesions. The detection rate of SWI was 16.8%. Compared with the other three methods, SWI had an advantage over the other three methods, and the difference was statistically significant (P0.05). The systolic blood pressure (SBP), diastolic blood pressure (DBP) in the two groups were significantly higher than those in the other three groups. Compared with the grade of cerebral infarction and white matter degeneration, the difference was statistically significant. The difference between the two groups in the area of microhemorrhage and cerebral infarction was statistically significant (P0.05). Conclusion the detection of CMBs foci in CMBs may increase the risk of HT, and has important clinical value in the treatment, outcome and prognosis of patients with cerebral infarction.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R445.2

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