摘要
目的探讨增强CT扫描对大面积脑梗死后出血性转化的预测价值。方法对2010年1月—2012年5月发病12 h内入我院的大脑中动脉区大面积梗死51例入院后急诊行头颅CT平扫,发病24～48 h行头颅CT平扫及增强扫描,行增强CT扫描者1周后行头颅CT平扫,分析头颅CT增强扫描造影剂外渗与出血性转化的关系。结果发病24～48 h头颅CT平扫均发现大脑中动脉区大面积脑梗死,额、颞、顶叶均受累,其中4例大面积缺血灶内有点、小斑片状高密度影,47例行增强CT扫描,12例出现病灶造影剂外渗强化。47例行增强CT扫描患者1周后复查头颅CT,14例发现出血性转化,其中12例为出现病灶造影剂外渗者。51例中18例(35.29%)出现出血性转化,其中15例(29.41%)为渗出型,3例(5.88%)为血肿型。结论急性大面积脑梗死后早期在传统CT平扫的基础上结合增强扫描能及早发现可能的出血性转化,有助于及时调整治疗方案,改善预后。
Objective To explore diagnostic value of enhancement CT for early hemorrhagic transformation of massive cerebral infarction in order to guide clinical therapy. Methods 51 patients with massive brain infarction in middle cerebral artery who fell ill within 12 hours during January 2010 to May 2012 in our hospital performed head plain CT scan, head plain CT scan and enhancement scanning within 24-48 h and head plain scan for patients who had enhancement scanning so as to analyze the relationship between visualization extravasation of head CT contrast enhanced scan with hemorrhagic conversion. Results Within 24-48 h after invasion massive cerebral infarction was found in middle cerebral artery area, involving in forehead, temples and parietal lobe, among which 4 patients with point or small patching massive hyperdense shadow in massive ischemic focus and 47 patients by enhancement CT scan among which 12 patients had focus extravasation of contrast media strengthening. The 47 patients by head plain CT scan reviewed 1 week later, among whom there were 14 patients with hemorrhagic conversion. Among 51 patients, there were 18 （35.29%） with hemorrhagic transformation, 15 （29.41%） with exudate and 3 （5.88%） with hematoma. Conclusion Enhancement CT scanning may help the prognostic diagnosis of early hemorrhagic transformation in massive brain infarction in order to improve prognosis.
出处
《解放军医药杂志》
CAS
2012年第11期41-43,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
脑梗死
出血性转化
体层摄影术
X线计算机
Cerebral infarction
Hemorrhagic transformation
Tomography, X-Ray computed
