卒中后出血转化的影像学评估 Imaging Evaluation of Post-stroke Hemorrhagic Transformation

Abstract

【摘要】 出血转化是缺血性卒中患者静脉溶栓及血管内治疗最严重的并发症之一，对于缺血性卒中患者，在考虑卒中急性期血流再灌注、避免血管再闭塞的同时，关注出血转化高风险人群的筛查是提高卒中治疗质量的关键之一。颅脑CT、CTA、MRI、DWI、SWI及灌注成像等多种神经影像学诊断技术可快速获取有关卒中性质、核心梗死灶体积、病灶及周围血流灌注状态、血管病变程度及病变血管管壁通透性等相关信息，以预测患者的出血转化风险，指导临床医师治疗措施的选择，从而改善患者预后。 【Abstract】 Hemorrhagic transformation (HT) is one of the most severe complications after endovascular revascularization or intravenous thrombolysis in patients with acute ischemic stroke. Identifying ischemic stroke patients who are at high risk of HT is crucial for guiding therapeutic strategies. Currently, there are a variety of neuroimaging techniques such as brain CT, CTA, MRI, DWI, SWI and perfusion imaging and etc. The information of stroke category, core infarct volume, vascular lesions, the perfusion state of ischemic lesion and perilesional area, the permeability of culprit vessel wall and so on can be rapidly obtained by the above imaging examination, which can be used to assess the risk of HT. In a word, the evaluation of HT risk is very helpful for clinicians to make optimal therapeutic strategy for stroke patients, to improve the prognosis of patients.

Keywords

• 缺血性卒中
• 出血转化
• 神经影像学技术
• ischemic stroke
• hemorrhagic transformation
• neuroimaging technique