深髓静脉征和皮质静脉征对急性脑卒中出血转化的预测研究

Study on prediction of the transformation of acute cerebral apoplexy with deep medullary vein sign and cortical vein sign

目的探讨3. 0T高分辨磁共振的磁敏感加权成像(susceptibility weighted imaging,SWI)对脑深髓静脉征(deep medullary vein sign,DMVS)和皮质静脉征(cortical veins sign,CVS)与急性脑卒中(acute ischemic stroke,AIS)的出血转化(hemorrhagic transformation,HT)之间关系,预测评估的临床应用价值。方法 60例AIS(<72h)均行常规MRI、SWI检查患者,利用SWI评估HT的类型,DMV和CVS与HT变化进行相关性分析。结果本组有60病例AIS中有30例HT,SWI显示有30例出血HT,DMVS有17例,DMVS无13例;CVS有9例,CVS无21例。30例AIS无HT,DMVS有10例,DWVS无20例,CVS有8例,CVS无22例。HT及无HT各30例病灶区周围有无DMVS的差异有统计学意义(2=4. 434,P=0. 037,<0. 05)。HT与无HT病灶区周围有无CVS无统计学意义(2=0. 082,P=0. 774,> 0. 05)。结论SWI图像上DMVS的信号改变可作为早期、快速预测脑卒中患者严重程度的影像学表现之一,对急性脑梗死HT预测,制定正确的治疗方案具有重要临床意义。

Objective To explore the relationship of hemorrhagic transformation（HT） of acute ischemic stroke（AIS） with deep medullary vein（DMVS） and cortical vein signs（CVS） by the means of 3. 0 T high resolution magnetic resonance magnetic sensitive weighted imaging（susceptibility weighted imaging,SWI） and to predict the application value in clinic. Methods 60 patients were all subjected to conventional MRI and SWI. The type of HT was assessed and the correlation analysis was conducted between DMV/CVS and HT. Results In those 60 patients,there were 30 of HT in 60 cases in this cohort. SWI showed that there were were 30 of HT,in which 17 presented with DMVS,13 without DMVS,9 presented with CVS,and 21 without CVS.There was statistically significant difference between DMVS and DMVS in 30 cases of HT and 30 cases without HT（2= 4. 434,P = 0. 037, 0. 05）. There was no statistically significant difference between HT and non-HT lesions（2= 0. 082,P = 0. 774, 〈0. 05）. Conclusion On the SWI image,DMVS signal change can be used as early,rapid prediction imaging findings of the severity of cerebral apoplexy patients,which has an important clinical significance for predicting HT of acute cerebral infarction and establishing the correct treatment and the judgement of prognosis in clinic.