【摘要】 目的 探讨脑梗死出血性转化(HT)的发生时间规律、MRI特征性表现及分型。方法 回顾性分析本院及外院72例HT病例(其中栓塞性脑梗死22例，血栓形成性脑梗死50例)的特点，观察其发生时间规律、MRI特征性表现，提出新的MRI分型。结果 HT多发生于发病后1周内，其中栓塞性脑梗死发生HT的高峰时间为第1～3天，血栓形成性脑梗死为第4～7天，两者间差异有统计学意义(P=0.017);MRI分型：Ⅰ型，幕上非血肿型；Ⅱ型，幕下非血肿型；Ⅲ型，血肿形成型；Ⅳ型，混合(幕上+幕下)非血肿型。结论 栓塞性和血栓形成性脑梗死发生HT的高峰时间不同；MRI分型综合考虑出血形态、出血部位及不同部位、不同出血形态的发生率，有助于指导临床治疗及判断预后。更多还原

【Abstract】 Objective To investigate the onset time, MRI characteristics and classification of hemorrhagic transformation in cerebral infarction.Methods Retrospective analysis was performed in 72 patients of hemorrhagic transformation in cerebral infarction(22 embolism infarction and 50 thrombosis infarction). We observed the regularity of onset time and MRI characteristics and gave new MRI classification. Results HT was happened mostly in the first week after symptom onset in cerebral infarction. The peak time of HT in embolism infarction(the 1-3th day) was earlier than thrombosis infarction( the 4-7th day)(P=0.017). We applied new MRI classification as: HTⅠ(supratentorial non-hematoma), HTⅡ(subtentorial non-hematoma),HTⅢ(hematoma), HTⅣ(mixed non-hematoma).Conclusion There are different peak time of HT between embolism infarction and thrombosis infarction. For this new classification, the position, shape of hemorrhage and the incidence rate of different position and shape hemorrhage are took into account, be useful to guide clinical treatment and prognosis judgement.更多还原