| Part ⅠAPPLICATION OF SWI IN ACUTE CEREBRA-L INFARCTIONCOMPLICATED WITH HEMORRHAGE Objective:To investigate the value of SWI in acute cerebral infarction complicated with hemorrhage Methods:Collecting patients who came to the emergency department and neurology department for acute cerebral infarction complicated with hemorrhage treatment in Taian City Central Hospital from December 2015 to December 2018.The patients mentioned above were all conducted MRI scan including routine magnetic resonance imaging(TIWI,T2WI),diffusion weighted imaging(DWI)and susceptibility weighted imaging(SWI).The numbers of patients complicated with hemorrhage,numbers of hemorrhagic foci and area of hemorrhage were analyzed.Results:There were 16 cerebral infarction patients with g less than 6h attacking time.;32patients with 6h-24h;3 patients with 24-72 h.The diameter of cerebral infarction area was less than 1.5 cm in 8 patients;From 1.5cm to 3.0cm in 13patients;and 30 patients with more than 3.0 cm.The hemorrhage area was detected by T1 WI in 23 patients,the positive rate was 45.10%.0 patients with less than 6h attacking time,4 patients between 6h to 24 h,and 19 patients between 24 h to 72 h.The hemorrhage area was detected by T2 WI in 28 patients,the positive rate was 54.90%,0 patients with less than 6h attackting time,5patients betweent 6h to 24 h,and 23 patients between 24 h to 72 h.The hemorrhage area was detected by DWI in 35 patients,the positive rate was 68.63%,1 patients with less than 6h attacking time,9 patients between6 h to 24 h,26 patients between 24 h to 72 h.The hemorrhage area was detected by SWI in 51 patients,the positive rate was 100.00 %,16 patients wih less than 6h attacking time,32 patients between 6h to 24 h,and 3 patients between 24 h to 72 h.The differences for detection rate of foursequences was statistically significant(P<0.05).The hemorrhage area was detected by T1 WI in 23 patients,the positive rate was 45.10%.The diameter of cerebral infarction area was less than 1.5cm in 2patients,1.5cm-3.0cm in 5 patients,and 16 patients with the diameter more than 3.0cm.The hemorrhage area was detected by T2 WI in 28 patients,the positive rate was 54.90%.The cerebral infarction diameter was less than 1.5cm in 3 patients,1.5cm-3.0cm in 6patients,and more than 3.0cm in 19 patients.The hemorrhage area was detected by DWI in35 patients,the positive rate was 68.63%.Among these patients,the cerebral infarction diameter was less then 1.5cm in 5 patients,1.5cm-3.0cm in 7 patients,23 patients with more than 3.0cm diameter;51 patients with hemorrhage were found by SWI,the positive rate is 100.00%.Amongthese patients,the cerebral infarction diameter was less then 1.5cm in 8 patients,1.5cm-3.0cm in 13 patients,and 30 patients with more than 3.0cm diameter.The positive ratio of the four sequences in detecting hemorrhage were significantly different(P<0.05).The 37,51,60,and 77 hemorrhagic lesions were found by the T1 WI,T2WI,DWI,and SWI respectively.The T1 WI and T2 WI sequences were used to detect the area of cerebral infarction,of which there were 16,31,20,7,3,and 0 hemorrhagic lesions with scores of 0,1,2,3,4,and 5 correspondingly;Therehwere 16,22,18,17,4,and 0 hemorrhagic lesions with scores of 0,1,2,3,4,and 5 correspondingly by DWI.There were 0,15,35,22,5,and 0hemorrhagic lesions with scores of 0,1,2,3,4,and 5 correspondingly by SWI.Conclusion:1.Compared with conventional MR sequences(T1WI,T2WI)and DWI,it has a higher detection rate in acute cerebral infarction complicated wih hemorrhage by SWI.SWI can show more hemorrhage lesions and a larger range of hemorrhage area.2.SWI can show the hemorrhagic foci which T1 WI,T2WI and DWI sequences fail to show,and is more sensitive in the diagnosis of cerebral infarction hemorrhage.3.SWI can detect earlier and smaller hemorrhagic foci in patients with cerebral infarction,which can provide strong evidence for the diagnosis of hemorrhagic cerebral infarction and provide guidance for clinical treatment.Part ⅡTHE PREDICTIVE DIAGNOSIS VALUE OF SWI ON THE RISK OF CEREBRAL HEMORRHAGE IN PATIENTS WITH CEREBRAL INFARCTION Objective:To detect the numbers and location of CMBs in patients with acute cerebral infarction using SWI,and to explore its predictive diagnostic value in cerebral infarction.Methods:Collecting patients who came to neurology department for acute cerebral infarction treatment in Taian City Central Hospital from December 2015 to December 2018.The numbers and location of CMBs were detected by SWI.All Patients mentioned above were treated with aspirin 100 mg or clopidogrel 75 mg.We used the phone,We Chat platform and out patient followup to understand the occurrence of cerebral hemorrhage,cerebral infarction recurrence and normal events 6 months after patients discharge.Results:1).Among the 52 Patients with acute cerebral infarction and CMBs,the number of CMBs was at least 1 and the maximum was 17.Among them,15 Patients were found to have 1CMB,12 patients wih 2-4 CMBs,and 10 patients with more than 5 CMBs.In the patients with acute cerebral infarction,there were 21 cases of CMBs located in the basal area and the cerebellum,19 caseslocated in the cortex and subcortical white matter,and 12 cases located in other parts.2).Among 52 Patients with acute cerebral infarction and CMBs,it developed into cerebral hemorrhage in 6 patients,the incidence rate was 11.54(6/52);cerebral infarction was recured in 9 patients,the incidence rate was 17.31%(9/52).Of the 45 patients with acute cerebral infarction without CMBs,6 patients had recurrent cerebral infarction,the incidence rate was 13.33%(6/45);there was no patients to develop into cerebral hemorrhage.The risk of developing into cerebral hemorrhage or cerebral infarction recurrence in patients with CMBs was higher than those without CMBs.3).The risk of cerebral hemorrhage after d patients discharge with acute cerebral infarction was positively correlated with the numbers of CMBs.The risk of cerebral hemorrhage were increasing with the numbers of CMBs.The risk was 0% without CMBs;risk 1.92% with 1CMBs,risk 3.84% with 2-4 CMBs;risk 5.77% with more than 5 CMBs.4).The risk of cerebral infarction recurrence after patients discharge with acute cerebral infarction did not increase with the increase in the numbers of CMBs.The risk was 13.33% without CMBs,risk 1.92% with 1 CMBs;risk 1.92% with 2-4 CMBs;risk 13.46% with more than 5 CMBs.However,the incidence of secondary cerebral infarction recurrence(16.49%)was higher than that of cerebral hemorrhage(6.18%).Conclusion:1.The patients with cerebral infarction was followed up for 6 months.The risk of cerebral infarction recurrence was higher than that of cerebral hemorrhage.2.The risk of cerebral hemorrhage in patients with cerebral infarction is positively related to the numbers of CMBs.The risk of cerebral infarction recurrence in patients with CMBs is higher than those without CMBs.3.To monitor the numbers and location of CMBs by SWI in patients with acute cerebral infarction,which can provide reliable imaging data for clinicians to assess the condition and prognosis outcome. |
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