Study On Hemorrhagic Transformation With Susceptibility Imaging Detection And Related Factors

Objective:To explore the application value of susceptibility weighted imaging detecting hemorrhagic transformation, the related factors and clinical outcome of hemorrhagic transformation after ischemic stroke.Methods:A total of120ischemic stroke subjects were included in the study. Firstly, all of them were examined cranial CT, routine MRI and SWI scan, detecting the incidence of hemorrhagic transformation. Secondly, we analyzed information about the risk factors, including infarct size, preventive anti-platelet aggregative and anticoagulant therapy, blood pressure, fasting blood glucose, coronary atherosclerotic heart disease, urinary protein, low-density lipoprotein cholesterol (LDL-c), platelet count(PLT), NTHSS score at admission, and analyzed the correlation of hemorrhagic transformation incidence with different levels of fasting blood glucose, low-density lipoprotein cholesterol, platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR) and NTHSS score at admission, as well as how to influent their clinical outcome used NIHSS score. Results:16.67%patients were occurred hemorrhagic transformation after acute ischemic stroke with CT scan; routine MRI could detect25.83%, while SWI could detect57.50%.In univariate analysis, the HT incidence were significantly higher in the groups of patients with the large infarct size, hypertension, diabetes mellitus, coronary atherosclerotic heart disease, albuminuria, not take measures of preventive anti-platelet aggregative and anticoagulant therapy before stroke, low LDL-c level, low PLT, high NIHSS score at admission. The higher of NIHSS score at admission, the lower of LDL-c level, the lower of PLT, the higher of HT incidence. At the same time, we found that HT group was not significantly different with NIHSS score at the time of admission and discharged, while non-HT group was contrary.Conclusion:We confirm that SWI is the sensitivity determines sequence of hemorrhagic transformation after acute ischemic stroke. Large infarct size, not take preventive anti-platelet aggregation or anti-coagulation agents before ischemic stroke, hypertension, diabetes mellitus, coronary atherosclerotic heart disease, albuminuria, low LDL-c level, low PLT and high NIHSS score at admission are associated with an increased risk of HT and poor prognosis.