脑梗死局部动脉溶栓后症状性颅内出血的影像预测

The Symptomatic Intracraninal Hemorrhage After Local Intraarterial Thrombolysis in Acute Ischemic Stroke:Predicting by Pretherapeutic Imaging

目的探讨颅脑计算机体层摄影术(computed tomography,CT)及数字减影血管造影(digital subtractedangiograp hy,DSA)对脑梗死局部动脉溶栓后早期症状性颅内出血(symptomatic intracraninalhemorrhage,SICH)的预测价值。方法回顾分析60例经局部动脉溶栓治疗的脑梗死患者,根据术后有无SICH分为出血组和未出血组,对比两组平扫CT和DSA影像。结果 5例确诊SICH,两组术前CT同一供血区内陈旧缺血病灶、DSA侧支循环分级及血管狭窄方面具有统计学差异。结论脑梗死局部动脉溶栓前影像学综合分析可以帮助预测SICH的发生。

Objective To evaluate the predicting of early symptomatic intracraninal hemorrhage （SICH） after local intra-arterial thrombolysis by nonconstrast CT and digital subtraction angiography （DSA） imaging in acute ischemic stroke. Methods Sixty cases of acute ischemic stroke performed local intra-arterial thrombolysis were retrospective analysis their nonconstrast CT and DSA. They were divided into two group according to whether the SICH were diagnosed after operation. The preoperative nonconstrast CT and DSA images of the two groups were compared. Results SICH were diagnosed in 5 cases. There were statistically significant difference between the two group in old low density on nonconstrast CT, collateral flow supply and the vessel stenosis on DSA. Conclusion Local intra-arterial thrombolysis in cerebral infarction in a comprehensive analysis of pre-imaging can help predict the occurrence of SICH.