CAJ | 학술논문

目的：通过对脑微出血灶的检测，探讨磁敏感加权成像技术在缺血性脑卒中患者动脉溶栓术后出血性转化(Hemorrhage transformation，HT)中的预见性。方法应用3.0T医用磁共振扫描仪，采用磁敏感加权成像(Susceptibility weighted imaging，SWI)及其他成像技术，对70例起病6 h内的急性脑缺血患者行MRI及SWI检查，动脉溶栓后48 h内复查CT或MRI。根据患者SWI上是否存在微出血灶将其分为微出血灶组和非微出血灶组，分析两组患者术后出血性转化的情况。结果70例患者中有脑微出血灶者23例(32.9%)，主要分布于丘脑-基底节区。其中轻度8例，中度10例，重度5例。动脉溶栓治疗后共7例患者出现出血性转化，微出血灶组6例，非微出血灶组1例，两组间差异具有统计学意义(P<0.05)；进一步分析发现，脑微出血灶分度与出血性转化分型之间存在一定的相关性(r=0.319，P<0.05)。结论脑微出血灶严重程度与溶栓治疗后出血性转化存在一定的相关性。
목적：통과대뇌미출혈조적검측，탐토자민감가권성상기술재결혈성뇌졸중환자동맥용전술후출혈성전화(Hemorrhage transformation，HT)중적예견성。방법응용3.0T의용자공진소묘의，채용자민감가권성상(Susceptibility weighted imaging，SWI)급기타성상기술，대70례기병6 h내적급성뇌결혈환자행MRI급SWI검사，동맥용전후48 h내복사CT혹MRI。근거환자SWI상시부존재미출혈조장기분위미출혈조조화비미출혈조조，분석량조환자술후출혈성전화적정황。결과70례환자중유뇌미출혈조자23례(32.9%)，주요분포우구뇌-기저절구。기중경도8례，중도10례，중도5례。동맥용전치료후공7례환자출현출혈성전화，미출혈조조6례，비미출혈조조1례，량조간차이구유통계학의의(P<0.05)；진일보분석발현，뇌미출혈조분도여출혈성전화분형지간존재일정적상관성(r=0.319，P<0.05)。결론뇌미출혈조엄중정도여용전치료후출혈성전화존재일정적상관성。
Objective To investigate the predict value of susceptibility-weighted imaging on hemorrhage transformation after intra-arteral thrombolysis via ditecting cerebral microbleeds. Methods MRI, SWI sequence and other imaging technigue were performed in all 70 patients with 6 hours after acute cerebral ischemia using GE 3.0 T MRI in this study. CT and MRI were performed with 48 hours after intra-arterial thrombolysis. They were divided into cerebral microbleed group and non-cerebral microbleed group according to SWI manifestation. Results The cerebral microbleeds were found in 23 cases of total 70 cases (32.9%). They were mainly located in thalamus and basal ganglia area. 8 cases had mild microbleeds,10 cases had moderate microbleeds and 5 cases had severe microbleeds. After in-tra-arterial thrombolysis, hemorrhage transformation was occurred in 7 patients, with 6 in cerebral microbleeds group and 1 in non-cerebral microbleeds group (P<0.05). Furthermore, the grading of cerebral microbeelds and the type of HT had certain correlation (r=0.319,P<0.05). Conclusion The severity of cerebral microbleeds has certain correla-tion with the type of HT after intra-arteral thrombolysis.