SWI与3D-PCASL联合应用对急性脑梗死出血转化的预测研究

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Abstract Abstract: Objective: To evaluate the clinical value of combined using 3.0T magnetic resonance magnetic susceptibility weighted imaging(SWI) and three dimensional pseudo continuous arterial spin labeling(3D-PCASL) in prediction of hemorrhagic transformation(HT) after acute cerebral infarction. Methods: Fifty-four cases of acute cerebral infarction(<72 h) were performed conventional MRI, 3D-PCASL and SWI. The SWI were used to assess the type of HT. Combined with SWI and 3D-PCASL, the infarction area, HT area and cerebral blood flow(CBF) of each patient were calculated and the correlation relationship among them were analyzed. Results: In 54 cases of acute cerebral infarction, 19 cases were HT, 13/19 cases were HI type, 6/19 cases were PH type. The average rCBF zone in HI or PH lesions and area around two types of the lesions were (32.787±10.876), (26.655±19.325), (26.033±10.930), (28.984±11.019) mL/(100g·min), the differences of rCBF in HI and PH lesions area difference was statistically significant(t=0.766, P=0.000, <0.01, t=0.834, P=0.041, <0.05). Within and around the 54 cases of acute cerebral infarction lesions, the high perfusion hemorrhage presented in 42.8% and 50% lesions, respectively. Normal perfusion and surrounding hemorrhage presented in 50% and 37.5% of lesions, respectively. Hypo-perfusion and the surrounding hemorrhage presented in 31.7% and 28.1% lesions, respectively. Acute cerebral infarction and HT lesion area and the surrounding low, normal, high perfusion of the t test analysis statistically significant(t=0.658, P=0.002, <0.01). Conclusion: Combined the SWI and 3D-PCASL is useful in prediction of HT after acute cerebral infarction.

Key words： Brain infarction Magnetic resonance imaging

Received: 26 August 2016

PACS:	Ｒ743.33
	Ｒ445.2

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I5/309

[1]中华医学会神经病分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志，2015，45（4）：246-257.
[2]Yassi N, Parsons MW, Christensen S, et al. Prediction of postsroke hemorrhagic transformation using computed tomography perfusion[J]. Stroke, 2013, 44(11): 3039-3043.
[3]Huang P, Chen CH, Lin WC, et al. Clinical applications of susceptibity weighted imaging in patients with major stroke[J]. J Neurol, 2012, 259(4): 1426-1432.
[4]戴艳芳，卢洁，李坤成. 磁敏感加权成像在脑血管疾病的研究进展[J]. 中华老年心血管病杂志，2013，15（7）：776-777.
[5]朱丽丽，徐凯，李绍东，等. 磁敏感成像检测缺血性脑卒中成像性转化的应用价值[J]. 中国临床医学影像杂志，2010，21（3）：190-192.
[6]董龙春，文小检，刘筠，等. SWI在预测缺血性脑卒中出血性转化中的价值[J]. 实用放射学杂志，2014，30（4）：561-564.
[7]文小检，刘筠，许亮. SWI对急性脑梗死出血性转化及早期预后的预测价值[J]. 临床放射学杂志，2015，34（1）：14-17.
[8]赵大聪，鲁广华，郭江，等. SWI在超急性大面积脑梗死中的应用价值[J]. 实用放射学杂志，2016，32（4）：514-517.
[9]Fiorelli M, Bastianeuo S, von Kunmaer R, et al. Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Study I(ECASS I) cohort[J]. Stroke, 1999, 30(11): 2280-2284.
[10]Biffi A, Halpin A, Towfighi A, et al. Aspirin and recurrent intracerebral hemorrhage in cerebral amyloid angiopathy[J]. Neurology, 2010, 75(3): 693-698.
[11]Alvaerz-Sabin J, Maisterra O, Santamarina E, et al. Factors influencing haemorrhagic transformation in ischaemic stroke[J]. Lancet Neurol, 2013, 12(3): 689-705.
[12]Khatri R, Mckinney AM, Swenson B, et al. Blood brain barrier, reperfusion injury, and hemorrhagic transformation in acute ischemic stroke[J]. Neurology, 2012, 79(1): 52-57.
[13]朗志谨，苗延巍，吴仁华，等. MRI新技术及在中枢神经系统肿瘤的应用[M]. 上海：上海科学技术出版社，2015：148-149.
[14]鱼博浪. 中枢神经系统CT和MR鉴别诊断[M]. 3版. 西安：陕西科学技术出版社，2014：15-68.
[15]Zaharchuk G, Do HM, Marks MP, et al. Arterial spin-labeling MRI can identify the presence and intensity of collateral perfusion in patients with moyamoya diseasel[J]. Stroke, 2011, 42(9): 2485-2491.
[16]李乾露，杨德雨，刘波，等. 脑供血侧支循环的影像学评估[J]. 中国卒中杂志，2015，10（3）：175-180.
[17]吕晋浩，娄昕. 脑侧支循环的MRI研究进展[J]. 中华放射学杂志，2016，50（7）：556-558.
[18]Berg D, Hochstrasser H. Iron metabolism in Parkinsonian syndromes[J]. Mov Disord, 2006, 21(9): 1299-1310.
[19]Soo YO, Yang SR, Lam WW, et al. Risk vs benefit of antithrombotic therapy in ischaemic stroke patients with cerebral microbleeds[J]. J Neurol, 2008, 255(8): 1679-1686.
[20]Tong KA, Ashwal S, Holshouser BA, et al. Diffuse axonal injury in children clinical correlation with hemorrhagic lesions[J]. Ann Neurol, 2004, 56(1): 36-50.
[21]Huang P, Chen CH, Lin WC, et al. Clinical applications of susceptibility weighted imaging in patients with major stroke[J]. J Neurol, 2012, 259(7): 1426-1432.
[22]王利，郑罡，赵铁柱，等. 动脉自旋标记技术在脑部疾病中的临床应用[J]. 生物医学工程学杂志，2013，30（1）：196-199.
[23]Gupta R, Yonas H, Gebel J, et al. Reduced pretreatment ipsilateral middle cerebral artery cerebral blood flow is predictive of symptomatic hemorrhage post-intra-arterial thrombolysis in patients with middle cerebral artery occlusion[J]. Stroke, 2006, 30(12): 2526-2530.
[24]吕达平，韩咏竹，李慎茂，等. 脑血管侧枝循环与缺血性脑血管病[J]. 临床神经病杂志，2007，20（3）：238-239.
[25]吕达平，韩咏竹，李慎茂，等. 脑血管侧支循环与缺血性脑血管病[J]. 临床神经病杂志，2007，20（3）：238-239.
[26]Viallon M, Altrichtre S, Pereira VM, et al. Combined use of pulsed arterial spin-labeling and susceptibility-weighted imaging in stroke at 3T[J]. Eur Neurol, 2010, 64(2): 286-296.