CAJ | 학술논문

目的：探讨脑梗死出血性转化(HT)的发生时间规律、MRI 特征性表现及分型。方法回顾性分析本院及外院72例HT 病例(其中栓塞性脑梗死22例，血栓形成性脑梗死50例)的特点，观察其发生时间规律、MRI 特征性表现，提出新的 MRI 分型。结果HT 多发生于发病后1周内，其中栓塞性脑梗死发生 HT 的高峰时间为第1~3天，血栓形成性脑梗死为第4~7天，两者间差异有统计学意义(P =0.017)；MRI 分型：Ⅰ型，幕上非血肿型；Ⅱ型，幕下非血肿型；Ⅲ型，血肿形成型；Ⅳ型，混合(幕上+幕下)非血肿型。结论栓塞性和血栓形成性脑梗死发生 HT 的高峰时间不同；MRI 分型综合考虑出血形态、出血部位及不同部位、不同出血形态的发生率，有助于指导临床治疗及判断预后。
목적：탐토뇌경사출혈성전화(HT)적발생시간규률、MRI 특정성표현급분형。방법회고성분석본원급외원72례HT 병례(기중전새성뇌경사22례，혈전형성성뇌경사50례)적특점，관찰기발생시간규률、MRI 특정성표현，제출신적 MRI 분형。결과HT 다발생우발병후1주내，기중전새성뇌경사발생 HT 적고봉시간위제1~3천，혈전형성성뇌경사위제4~7천，량자간차이유통계학의의(P =0.017)；MRI 분형：Ⅰ형，막상비혈종형；Ⅱ형，막하비혈종형；Ⅲ형，혈종형성형；Ⅳ형，혼합(막상+막하)비혈종형。결론전새성화혈전형성성뇌경사발생 HT 적고봉시간불동；MRI 분형종합고필출혈형태、출혈부위급불동부위、불동출혈형태적발생솔，유조우지도림상치료급판단예후。
Objective To investigate the onset time,MRI characteristics and classification of hemorrhagic transformation in cere-bral infarction.Methods Retrospective analysis was performed in 72 patients of hemorrhagic transformation in cerebral infarction (22 embolism infarction and 50 thrombosis infarction).We observed the regularity of onset time and MRI characteristics and gave new MRI classification.Results HT was happened mostly in the first week after symptom onset in cerebral infarction.The peak time of HT in embolism infarction (the 1-3th day)was earlier than thrombosis infarction (the 4-7th day)(P =0.01 7).We ap-plied new MRI classification as:HTⅠ (supratentorial non-hematoma),HTⅡ (subtentorial non-hematoma),HTⅢ (hematoma), HTⅣ (mixed non-hematoma).Conclusion There are different peak time of HT between embolism infarction and thrombosis infarc-tion.For this new classification,the position,shape of hemorrhage and the incidence rate of different position and shape hemorrhage are took into account,be useful to guide clinical treatment and prognosis judgement.