SWI在经皮冠状动脉介入术后脑微出血评估中的价值

Value of SWI in the Evaluation of Cerebral Microbleeds after Percutaneous Coronary Intervention

目的:探讨磁敏感加权成像在经皮冠状动脉介入术后服用抗凝药物脑微出血评估中的价值。方法:收集2012-2017年聊城市人民医院心内科经皮冠状动脉介入治疗术后连续服用1种以上抗凝药物1年以上患者248名,术前、术后1年均行颅脑磁敏感加权成像扫描及常规MRI序列扫描。由2位高年资影像科医师共同阅读患者磁共振图像,分析经皮冠状动脉介入治疗患者脑内微出血的术前、术后数目变化。结果:术前根据临床出血风险CRUSADE评分系统将其分为2组:极低危-中危组226例,高危-极高危组22例。经皮冠状动脉介入治疗患者脑内微出血灶数目变化(0-4)227例,脑内微出血灶数目变化(≥5)21例。两组间脑内微出血灶数目比较,差异具有统计学意义,高危-极高危组脑内微出血灶数目高于极低危-中危组。结论:磁敏感加权成像可以很好地评估经皮冠状动脉介入治疗术后服用抗凝药物脑微出血变化,从而为经皮冠状动脉介入治疗术后个性化抗血小板治疗、减少大出血或重要器官出血风险发生、改善患者预后提供客观依据。

Objective:To explore the value of susceptibility-weighted imaging in the evaluation of intracerebral microbleeds after percutaneous coronary intervention.Methods:248 patients who took more than one anticoagulant drug continuously for more than one year after percutaneous coronary intervention in the Department of Cardiology of Liaocheng people's Hospital from 2012 to 2017 were collected.Susceptibility-weighted imaging scanning and conventional MRI sequence scanning were performed before and 1 year after percutaneous coronary intervention.Results:According to the clinical bleeding risk Crusade scoring system,they were divided into two groups:226 cases in the very low-risk to medium-risk group and 22 cases in the high-risk to very high-risk group.The number of cerebral microbleeds in PCI patients changed(0-4)in 227 cases,and the number of cerebral microbleeds changed(≥5)in 21 cases.There was significant difference in the number of cerebral microbleeds between the two groups.The number of cerebral microbleeds in high-risk high-risk group was higher than that in very low-risk medium-risk group.Conclusion:Susceptibility-weighted imaging can well evaluate the changes of cerebral microbleeds after percutaneous coronary intervention,so as to provide an objective basis for personalized antiplatelet therapy after percutaneous coronary intervention,reduce the risk of massive hemorrhage or important organ hemorrhage and improve the prognosis of patients.