出血性脑梗死的MRI特征性表现及其分型

MR imaging characterization and classification of cerebral hemorrhagic infarction

目的:探讨出血性脑梗死(HI)的MRI特征性表现和分型。方法:采用1.5T MR,对50例HI行常规序列扫描(T1WI、T2WI、FLAIR)。必要时行MRA(42例)、增强扫描(4例)及T2*WI(27例)。结果:根据梗死、出血的形态、部位进行MRI分型。Ⅰ型:脑叶HI:22例(44.0%)脑回状、斑片状出血位于皮层和/或皮层下白质。Ⅱ型:脑深部(基底节及丘脑)HI:17例(34.0%);Ⅲ型:小脑HI:14例(28.0%);斑片状、线状出血位于梗塞区内、边缘。混合型(Ⅰ型+Ⅱ型):3例(6%)。T2*WI呈低信号。结论:HI的MRI表现有一定特征性,与脑梗死部位、面积有密切关系。新的MRI分型有助于对HI发生机制的理解,从而指导临床治疗。T2*WI有助于HI的检出。

Objective：To assess the MR image characterization and classification of hemorrhagic infarction（HI）. Methods：50 cases with HI were detected by 1.5T MR imaging. Routine MR/（T1WI, T2WI, FLAIR）were performed. Necessarily,42 cases used MRA and 27 cases were performed T2＊WI. Results： According to the shape or position of infarction and hemorrhage, MRI type was typed T （44.0%）. In 22 patients the HI limited in brain lobes, hemorrhage located in cortex and/or subcortical white matter with patch border or brain gyrus like Ⅱ （34.0%）. In 17 patients HI limited in deep part of brain and HI located in deep part or boundary with patch border or line-like Ⅲ （28.0%）. In 14 patients HI limited in cerebellum and HI located in deep part or boundary with patch border or line-like, mixed： （6%）. In 3 patients HI involved brain lobe and deep part. T2 ＊ WI showed low signal. Conclusion：There are typical manifestations of MRI in HI, and the new MRI type is useful to comprehend the development mechanism of HI and to guide clinical treatment. T2＊WI is helpful to the detection of HI.