CT与MRI对脑梗死后出血性转变的诊断价值

Diagnostic values of CT and MRI for hemorrhagic transformation after cerebral infarction

目的探讨CT与MRI在脑梗死后出血性转变(HT)中的诊断价值。方法对2011-01—2014-04我院收治的45例HT患者的临床资料进行回顾性分析,对CT与MRI的检查结果进行对比。结果45例患者中,脑内血肿34例(75.6%),脑梗死病灶内片状、斑点状或条状出血11例(24.4%)。其中大面积脑梗死继发出血24例(53.3%),中等面积继发出血15例(33.3%),小面积脑梗死继发出血6例(13.3%);CT检出HT 10例(22.2%),MRI检出45例(100%),差异有统计学意义(P<0.05);在对不同部位的HT检查中,CT检出幕上出血9例(20.0%),幕下出血1例(2.2%);MRI检出幕上出血39例(86.7%),幕下出血6例(13.3%)。MRI对幕上及幕下出血的检出率均优于CT(P<0.05)。结论在HT的诊断中,MRI比CT更加准确和敏感,在判断出血时间、指导临床治疗以及预后判断中具有重要意义。

Objective To discuss the diagnostic values of CT and MRI for hemorrhagic transformation（HT）after cerebral infarction.Methods 45 patients with HT from two hospitals from January 2011 to April 2014 were chosen as research objects.Their clinical data were retrospectively analyzed and outcomes of CT and MRI were compared.Results Among 45 patients,there were 34cases（75.6%）with intracerebral hematoma,11cases（24.4%）with sheet,spot and strip hemorrhage in focus of cerebral infarction.Among them,there were 24cases（53.3%）with secondary hemorrhage after large cerebral infarction,15cases（33.3%）with hemorrhage secondary to medium area of infarction,and 6cases（13.3%）with hemorrhage secondary to little area of infarction.10cases（22.2%）with HT were detected by CT and 45cases（100%）were detected by MRI（P〈0.05）;9cases（20.0%）of supratentorial hemorrhage and 1case（2.2%）of subtentorial hemorrhage were detected by CT while 39cases（86.7%）of supratentorial hemorrhage and 6case（13.3%）of subtentorial hemorrhage were detected by MRI（all P〈0.05）.Conclusion MRI has more accuracy and sensitivity than CT in diagnosis of HT,which has great significance in judgment of bleeding time,guidance of clinical treatment and judgment of prognosis of disease.