目的 探讨磁敏感加权成像(SWI)对脑梗死后出血性转化(HT)的诊断价值,以及HT发生的影响因素分析.方法 90例脑梗死患者,分别进行SWI检查,CT扫描以及常规磁共振成像(MRI)检查,比较HT的检出率;采用磁敏感加权成像(SWI)检查方法比较脑梗死患者不同病理特征 、年龄(≥60岁)、吸烟史 、高血糖 、高血压 、高血脂以及心房颤动下HT的检出率,并进行单因素及Logistic回归分析.结果 SWI的HT检出率显著高于CT扫描以及常规MRI检查,差异有统计学意义(P<0.05);单因素方差分析结果表明,病理分期 、TOAST分型 、梗死面积 、年龄(≥60岁)、高血糖 、高血压以及心房颤动等因素均与HT的发生关系较为密切;Lo-gistic回归分析结果表明,高血糖 、高血压 、梗死面积 、年龄(≥60岁)、心房颤动及分期均是HT发生的高危因素.结论 SWI可作为临床诊断脑梗死后HT的首选方案,HT的发生与高血糖 、高血压 、梗死面积 、年龄(≥60岁)、心房颤动以及病理分期等关系较为密切.%Objective To investigate the value of SWI in the diagnosis of hemorrhagic transformation (HT ) after cerebral infarction ,and to analyze the influencing factors of HT .Methods Ninety cases of patients with cer-ebral infarction were examined by SWI ,CT scan and conventional MRI ,respectively .HT detection rates of three detection were compared ,detection rate of HT by SWI examination of patients with different pathological features of cerebral infarction ,age ( ≥ 60) ,smoking history ,hyperglycemia ,hypertension ,hyperlipoidemia and atrial fi-brillation were compared ,and single factor analysis and logistic regression analysis were performed .Results The detection rate of SWI in total HT and at different time points were significantly higher than those of CT scan and routine MRI examination ,the difference was statistically significant (P< 0 .05) .The single factor variance analy-sis showed that pathological stage ,TOAST type ,infarct size ,age ( ≥ 60) ,hyperglycemia ,hypertension and fac-tors of atrial fibrillation were closely related to the occurrence of HT .Logistic regression analysis showed that hy-perglycemia ,hypertension ,infarct size ,age ( ≥ 60) ,atrial fibrillation and pathological stage are the risk factors of HT .Conclusion SWI can be used as the first choice for clinical diagnosis of HT after cerebral infarction .Hyper-glycemia ,hypertension ,infarct size ,age ( ≥ 60) ,atrial fibrillation and pathological stage were closely related to the occurrence of HT .
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