摘要
目的探讨多模式MRI在超急性期缺血性脑卒中溶栓治疗中的应用价值。方法通过对发病12h内的缺血性脑卒中患者116例行CT平扫及MR快速成像序列检查，共筛选界定为超急性期缺血性脑卒中41例（35．3％），并对其中33例患者行重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓治疗及定期MR复查随访。结果33例超急性期缺血性脑卒中患者行溶栓治疗后均预后良好，90d改良Rankin评分均≤2分（平均1分），生活质量Barthal指数80—100分（平均95分）；5例溶栓治疗后发生无症状性脑出血（15．2％），其中1例为溶栓治疗后1周并发脑内血肿（PH1型），另4例溶栓治疗后6～24h出现梗死局部少许渗血（HI型）。结论在超急性期缺血性脑卒中溶栓治疗中，MRI对患者筛选界定和溶栓后复查均有较大应用价值，MRI指导的超急性期缺血性脑卒中静脉溶栓治疗是一种安全、有效的治疗方法。
Objective To investigate the value of MRI in thrombolytic therapy of hyperacute cerebral arterial thrombosis. Methods One hundred and sixteen patients with acute cerebral arterial thrombosis were recruited, plain CT and multi-modal MRI were performed in all patients. Thirty-three patients with hyperacute cerebral infarction were treated by recombinant tissue plasminogen activator（rt-PA） and followed-up periodically using MRI. Results The 33 patients with thrombolysis selected by MRI demonstrated clinical improvement, 90 d modified Rankin scale scores （mRs） were less than 2 and life quality Barthal indexes（BI） were from 80 to 100. The complication included one asymptomatic parenchymal hematoma（PH 1 ） one weeks after thrombolytic therapy and 4 （ 12. 2% ） hemorrhagic infarction（HI） 6 to 24 hours after thrombolytic therapy. Conclusions MRI has significant clinical value for the screening and follow-up of intravenous thrombolytic therapy of hyperacute ischemic stroke. MRI-based thrombolysis is a safe and effective method for hyperacute ischemic stroke.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第3期239-243,共5页
Chinese Journal of Radiology
基金
“十一五”国家科技支撑计划重点项目（2007BAI05B07,2006BAI01A11）
上海浦东卫生系统重点学科建设基金（PWZXK2007-14）
上海浦东科技发展创新基金及社发局基金（PKJ2006-Y03,PW2007A-24）
关键词
脑血管意外
血栓溶解疗法
磁共振成像
Cerebrovascular accident
Thrombolytic therapy
Magnetic resonance imaging
