出血性脑梗塞临床与CT、MRI分析

The Study of Clinical and CT & MRI Scans in Brain Hemorrhagic Infarction

目的 探讨出血性脑梗塞的发病机制及与头 CT、MRI的相互关系。方法 结合临床资料对 32例出血性脑梗塞的 CT、MRI结果进行分析。结果 出血性脑梗塞多发生在脑梗塞后第 3天～ 3周 ,病后 2周发生的出血性脑梗塞是由于闭塞血管的再通 ,出血量较大 ,患者临床症状加重或持续不缓解 ,此时 CT可清楚显示梗塞后的出血 ;病后 2周后发生的出血性脑梗塞是由于侧支循环的建立 ,梗塞区域发生渗血 ,出血量较小 ,患者临床症状缓解 ,此时 MRI可清楚显示梗塞后的出血 ,血 CT无明显改变。CT及 MRI均可清楚显示梗塞后的出血 ,但 MRI对斑点状出血的高显率和对亚急性出血的显示 ,使 MRI对出血性脑梗塞的诊断率更优于 CT。结论 CT、MRI均为诊断出血性脑梗塞的可靠手段 ,MIR更为优越。

Objective To explore the relationship between the mechanism of hemorrhagic infarction(HI) and computed tomography(CT) & magnetic resonance imaging(MRI) scans.Methods The clinical and CT & MRI data in 32 cases with HI were analyzed.Results HI that occured within 2 weeks from the onset of the ischemic stroke was due to the recanalization of obstacle vessels and the bleeding was more and the clinical manifestation was worsen or unrelieved.Meanwhile,the hemorrhage was visualized with CT.HI that occurred after 2 weeks from the onset was due to the formation of collateral circulation and exudation in the infarction site, and the bleeding was less and the clinical manifestation was relieved.The hemorrhage was obviously visualized with MRI,while was no change on CT.Thus hemorrhage after infarction was detected with both CT and MRI,spotty and subacute bleeding was visualized with MRI more than with CT,which made MRI superior to CT for diagnosis of HI.Conclusion Both CT and MRI were reliable for diagnosis of HI,while MRI was superior to CT.