The Correlative Study Between MR Classification Of Hemorrhagic Transformation Of Brain Infarction And Clinical Outcome

The Correlative Study between MR Classification of Hemorrhagic Transformation of Brain Infarction and Clinical OutcomePurposeWe intend to (1) establish a MR classification method of hemorrhagic transformation(HT) of brain infarction; (2) investigate the correlative relation between MR classification of HT of brain infarction and clinical outcome;(3)ascertain the risk factors of brain infarction, HT and poored outcome.Then investigate the applicative value of MR classification method of brain infarction HT on assessment clinical outcome.MethodsReview 421 acute brain infaction cases, who were examined and cured in our hospital from October 2007 to November 2009. All cases had high signal in DWI images performed at 3-7 days after stroke onset.31 HT cases were classificated by our own MR classification method. Investigate the correlative relation between MR classification of HT of brain infarction and clinical outcome. Study outcomes were 3-month mortality or disability. Disability was assessed using the modified Rankin score(mRs). Outcomes in patients with and without HT were compared by X2 test. T test was used between two groups. Multiple logistic regression analysis was used to identify predictors for brain infarction and HT. P<0.05 means the conclusions have statistical significance.ResultsIn all 421 cases,31cases (7.4%) had HT:I-grade:1case(0.24%),lesion in the anterior or posterior circulation,diameter<1.5cm, had small petechiae or confluent petechiae or cortical hemorrhage.â…¡-grade:9 cases (2.1%),lesion in the cortical or deep branch of anterior cerebral artery(ACA) or middle cerebral artery(MCA),diameter> 1.5cm, had small petechiae or confluent petechiae or cortical hemorrhage.â…¢-grade:4 cases (0.95%), lesion involving brain stem or cerebellum>1.5cm,had small petechiae or confluent petechiae hemorrhage. IV-grade:14cases (3.3%), lesion involving complete territory of ACA or MCA, or lesion involving 2 branch of them, had hematoma without space-occupying. V-grade: 3cases(0.7%), lesion involving complete territory of ACA or MCA,or lesion involving 2 branches of them, had hematoma with space-occupying.3-month mRs:165 cases (39.2%) had disability (mRs3-5) or dead,35 cases (8.3%) dead. In 31 HT cases, 20 cases (4.8%) had disability or dead. Multiple logistic regression analysis showed that III-grade HT (OR1.46; 95%CI 1.33-1.52),â…£-grade HT (OR1.94; 95%CI 1.82-2.17),â…¤-grade HT (OR4.25; 95%CI 4.02-4.45) had significance relationship with poored outcomes. Serious I-grade infaction (OR4.78; 95%CI 4.62-5.25),recurrence stroke (OR3.25; 95%CI 3.05-3.56),hypertension (OR2.58; 95%CI 2.36-2.82),diabetes(OR3.25;95%CI 3.05-3.56)>NIHSS(OR1.23;95%CI 1.15-1.33) were the risk factors of HT.Conclusions7.4%acute brain infactionshad HT, brain stem or cerebellum HT,large area HT had significance relationship with poored outcomes; Serious I-grade infaction,recurrence stroke,hypertension,diabetesand NIHSS were the risk factors of HT. MR classification method of hemorrhagic transformation(HT) of brain infarction had significance relationship with outcomes.