磁敏感加权成像在诊断急性缺血性脑卒中静脉溶栓后出血转化中的应用

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Abstract Objective To investigate the application effect of hemorrhagic transformation (HT) after intravenous thrombolytic therapy with alteplase in acute ischemic stroke (AIS) patients by susceptibility weighted imaging ( SWI). Methods Clinical data of 855 AIS patients who received intravenous alteplase therapy in Emergency Department of Linyi People′s Hospital Brain Hospital of Shandong Province from January 2016 to June 2018 were retrospectively analyzed, all patients were given SWI and brain CT detection respectively, two imaging methods were compared on the identification of cerebral hemorrhage after thrombolysis, and the incidence of cerebral hemorrhage of patents with different ECASS classification was observed. Results There were 133 (15.6%) patients with HT detected by SWI after thrombolysis, including 79 cases of hemorrhagic infarction (HI) -1, 33 cases of HI-2, 12 cases of parenchymal hematoma (PH) -1 and 9 cases of PH-2. There were 103 (12.0%) patients with HT detected by CT after thrombolysis, including 53 cases of HI-1, 29cases of HI-2, 12 cases of PH-1 and 9 cases of PH-2. The bleeding rate of HI-1 detected by SWI was higher than CT, the difference was statistically significant (P < 0.05); there was no statistically significant difference between the other types (P > 0.05). Conclusion SWI has a higher value in the detection of HT after intravenous thrombolytic therapy, with important clinical significance in the guidance of the antiplatelet or anticoagulant therapy for AIS patients．

Key words： Susceptibility weighted imaging Intravenous thrombolytic therapy Acute ischemic stroke Hemorrhagic transformation

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	WANG Ziran1 CUI Yansen1▲ ZHAO Guangjian1 ZHENG Mei1 DAI Shouping2 LIU Shulan2 SUN Quanyu2

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WANG Ziran1 CUI Yansen1▲ ZHAO Guangjian1 ZHENG Mei1 DAI Shouping2 LIU Shulan2 SUN Quanyu2. Application of SWI in the hemorrhagic transformation after intravenous thrombolytic therapy with alteplase in patients with acute ischemic stroke[J]. 中国医药导报, 2019, 16(22): 155-157.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I22/155

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