脑梗死出血性转化的CT、MRI影像特点分析

目的探讨脑梗死出血性转化的CT、MRI影像特点。方法回顾性分析2013年6月-2016年6月我院收治的经手术病理证实的32例脑梗死出血性患者临床资料,均行CT及MRI检查,总结病例患者影像学特点。结果脑梗死出血性转化的CT影像学特点:(1)梗死区域有明显斑片状高密度影,病灶影边缘模糊;(2)出血量较大病灶表现为团块状(不规则型,有典型占位表现);(3)出血量较小病灶经CT检查时常被掩盖;(4)CT增强扫描病灶梗死区域内可见脑回状、斑片状亦或团块状强化,而病灶分为中心型(9例)、边缘型(11例)及混合型(12例)三类。MRI影像学特点:(1)出血后急性期出血灶T2像上呈低信号,稍高于脑内血肿患者的信号;(2)亚急性期出血灶影像学信号以短T1及长T2信号为主;(3)慢性期血灶信号以T2像亦或梯度回波图像上清晰可见含铁血黄素沉着形成的特征性的低信号为主;(4)MRI增强扫描可见病灶梗死区内有明显脑回状、斑片状亦或团块状强化信号影。结论脑梗死出血性转化患者CT及MRI影像特点各具特异性,总结2种影像学表现特点对治疗方案的制定提供重要参考。

Imaging Features of CT and MRI in Hemorrhagic Transformation of Cerebral Infarction

Objective To investigate the imaging features of CT and MRI in hemorrhagic transformation of cerebral infarction.Methods The clinical data of 32 patients with cerebral infarction hemorrhage confirmed by surgery and pathology in our hospital between June 2013 and June 2016 were retrospectively analyzed.All patients underwent CT and MRI examination,and the imaging features were summarized.Resuts CT imaging features of hemorrhagic transformation of cerebral infarction:①there was obviously patchy and high-density shadow in infarction area,edges of lesions were blur.②lesions with more hemorrhage were crumby (irregular,with typical space-occupying features).③lesions with little hemorrhage was often covered when undergoing CT examination.④CT enhanced scan of infarction area showed gy riform,patchy or nodular enhancement.The lesions were central type (9 cases),peripheral type (11 cases) and mixed type (12 cases).MRI imaging features.①in acute phase after hemorrhage,hemorrhagic lesions showed low signal on T2,slightly higher than that in patients with intracerebral hematoma.②in subacutephase,the main imaging signal of hemorrhagic lesions was short T1 and long T2 signal.③in chronic phase,the main imaging signal of hemorrhagic lesions was clearly visible tipical low signal formed by hemosiderosis on T2 or gradient echo image.④MRI enhanced scan showed that there was obvious gyriform,patchy or mass like enhancement signal in infarction area.Conclusion The CT and MRI features of hemorrhagic transformation of cerebral infarction are special.Summary of the findings of the two imaging methods can provide important reference for the development of treament plan.