[1]赵俊功,李明华,方淳,等.急性脑梗死动脉溶栓后即刻CT图像颅内高密度病灶的鉴别[J].介入放射学杂志,2007,(03):148.
 Differential diagnosis of hyperdensities on computed tomography immediately after intra-arterial thrombolysis in patients with acute ischemic stroke ZHAO Jun-gong,LI Ming-hua,FANG Chun,et al.Differential diagnosis of hyperdensities on computed tomography immediately after intra-arterial thrombolysis in patients with acute ischemic stroke[J].journal interventional radiology,2007,(03):148.
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急性脑梗死动脉溶栓后即刻 CT 图像颅内高密度病灶的鉴别()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年03期
页码:
148
栏目:
神经介入
出版日期:
2007-03-15

文章信息/Info

Title:
Differential diagnosis of hyperdensities on computed tomography immediately after intra-arterial thrombolysis in patients with acute ischemic stroke
作者:
赵俊功李明华方淳
200233上海交通大学附属第六人民医院放射科
Author(s):
Differential diagnosis of hyperdensities on computed tomography immediately after intra-arterial thrombolysis in patients with acute ischemic stroke ZHAO Jun-gongLI Ming-huaFANG ChunWANG JuZHANG Pei-leiDU Zhuo-yingLI Min.
Department of Radiology,Sixth Hospital Affiliated to Shanghai Jiaotong University,Shanghai200233,China
关键词:
脑缺血溶栓治疗血脑屏障
分类号:
R735.7
文献标志码:
A
摘要:
目的分析急性脑梗死动脉溶栓后即刻CT平扫图像颅内高密度灶的类型及其临床意义。方法在发病6h内接受动脉、静脉联合溶栓治疗的急性脑梗死患者22例,溶栓前均接受CT、MRI检查并被证实为急性脑梗死且排除合并的脑出血。对梗死动脉溶栓后即刻CT图像颅内高密度病灶进行了回顾性分析。结果经动静脉联合溶栓治疗后,溶栓后即刻CT图像上出现高密度灶5例,发生率为22.7%(5/22)。根据其位置、CT值和24h随访结果,溶栓后即刻CT图像颅内高密度病灶被分为2类,即对比剂增强和脑出血转化。其中,表现为对比剂增强2例,即高密度病灶呈脑回状或片状,CT值小于90HU,24h CT复查高密度灶消失;3例表现为脑出血转化,即CT值大于90HU、24h CT复查高密度依然存在。2例对比剂增强患者,未作特殊处理,临床症状改善明显。结论动脉溶栓后即刻CT图像上出现高密度病灶并非都是脑出血转化。根据其分布、CT值的大小,必要时24h CT复查进行鉴别有助于患者的正确处理。

参考文献/References:

[1]Yoon W,Seo JJ,Kim JK,et al.Contrast enhancement and contrast extravasation on computed tomography after intra-arterial thrombolysis in patients with acute ischemic stroke[J].Stroke,2004,35:876-881.
[2]Mori E,Yoneda Y,Tabuchi M,et al.Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke[J].Neurology,1992,42:976-982.
[3]Mericle R,Lopes DK,Fronckowiak MD,et al.A grading scale to predict outcomes after intra-arterial thrombolysis for stroke complicated by contrast extravasation[J].Neurosurgery,2000,46:1307-1315.
[4]Nakano S,Iseda T,Kawano H,et al.Parenchymal hyperdensity on computed tomography after intra-arterial reperfusion therapy for acute middle cerebral artery occlusion:incidence and clinical significance[J].Stroke,2001,32:2042-2048.
[5]Trouillas P,Kummer R.Classification and pathogenesis of cerebral hemorrhages after thrombolysis in ischemic stroke[J].Stroke,2006,37:556-561.

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备注/Memo

备注/Memo:
收稿日期:2006-06-09
更新日期/Last Update: 2007-03-15