脑梗死后出血性转换的特征性影像表现及分型

目的 :探讨脑梗死后出血性转换的特征性影像表现和分型。方法 :回顾性总结 65例梗死后出血性转换患者的MRI表现。其中 5 2例 96人次行CT检查 ,2 3例行MRIGd DTPA增强T1扫描。结果 :脑叶梗死 16例 ,出血位于皮质(14例 )和皮层下白质 (2例 ) ,出血形态主要为脑回状 (13例 )和斑片状 (2例 ) ;脑深部梗死 2 1例 ,出血均位于深部 (2 1例 ) ,其中 2例合并脑室内积血 ,出血形态主要为团状 (10例 )和点状 (7例 ) ;梗死范围包括脑叶和深部 2 8例 44个出血性病灶 ,其中 2 2个病灶出血位于皮质 ,8个病灶位于皮层下白质 ,14个病灶位于深部 ,2例合并脑室内积血 ,出血性病灶主要为脑回状 (2 0处 )和团状 (16处 )出血。结论 :继发出血性转换的影像学表现与脑梗死的范围有密切关系。ECSASS分型对脑卒中预后和临床治疗有指导价值

Image characterization and classification of secondary hemorrhagic transformation after cerebral infarct

Objective:To study the image characterization and classification of secondary hemorrhagic transformation (HT) after cerebral infarct.Methods:A retrospective study involving 65 HT patients detected by MR imaging was performed.Enhanced T 1 weight imaging after Gd-DTPA injection was carried out in 23 cases.In all 65 patients,56 cases for 92 times underwent CT scan.Results:In 16 patients the infarction limited in brain lobs,in which 14 cases HT located in cortex and 2 cases located in subcortical white matter.In 21 patients infarction limited in deep part of brain and HT located in all cases in deep part.In 28 patients infarction with 44 hemorrhagic foci involved brain lobe and deep part,in which 22 hemorrhagic foci were observed in cortex and 8 in white matter under cortex and 14 in deep part.Conclusion:The image findings of secondary HT are related to the position and extent of infarction.The HT classification by ECSASS has great value to clinical treatment and outcome in stroke.