A study on application value of susceptibility weighted imaging combined with platelet distribution width in intravenous thrombolysis for treatment of patients with acute cerebral infarction
10.3969/j.issn.1008-9691.2019.01.024
- VernacularTitle:磁敏感加权成像联合血小板分布宽度在急性脑梗死患者静脉溶栓治疗中的应用价值研究
- Author:
Huan QIU
1
;
Wenping LIU
;
Risheng YU
Author Information
1. 浙江大学医学院附属第二医院放射科
- Keywords:
Sensitivity weighted imaging;
Platelet distribution width;
Intravenous thrombolysis;
Acute cerebral infarction,
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2019;26(1):88-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of susceptibility weighted imaging (SWI) combined with platelet distribution width (PDW) in intravenous thrombolysis for treatment of patients with acute cerebral infarction (ACI). Methods One hundred and ten patients with ACI treated by intravenous thrombolysis admitted to the Department of Radiology of the Second Affiliated Hospital of Medical College of Zhejiang University from February 2017 to June 2018 were enrolled as the subjects. Before treatment, all patients were detected by routine magnetic resonance imaging (MRI), SWI scanning and PDW detection. The patients were divided into hemorrhage group (77 cases) and non-hemorrhage group (33 cases) according to the presence or absence of hemorrhage shown in SWI, and according to the amount of bleeding, the hemorrhage group patients were subdivided into light (24 cases), medium (32 cases) and severe (21 cases) three groups. After intravenous thrombolysis, the patients were scanned by SWI to show whether bleeding being present or not, the cerebral microbleeding (CMBs) after 24 hours treatment in two groups, and after treatment of 14 days, modified Rankin score (MRS), PDW and hemorrhagic transformation (HT) situation in the two groups were evaluated and compared, the differences in hemorrhagic infarction 1 (HI1), hemorrhagic infarction 2 (HI2), parenchymal hemorrhage 1 (PH1) and parenchymal hemorrhage 2 (PH2) in different bleeding volume groups were compared. Results Before treatment, 129 lesions detected by SWI were significantly greater than 14 lesions detected by T1 weighted imaging, 22 lesions detected by T2 weighted imaging and 86 lesions detected by diffusion weighted imaging. After treatment for 24 hours, the number of CMBs (number: 10 vs. 0), after treatment for 14 days, the incidence of HT [36.36% (28/77) vs. 12.12% (4/33)], MRS (1.78±0.39 vs. 1.51±0.42) and PDW [(12.34±5.29)% vs. (6.79±3.27)%] in the hemorrhagic group were higher than those in non-hemorrhagic group (all P < 0.05). After treatment of 14 days, the incidences of HT [71.43% (15/21) vs. 20.83% (5/24), 25.00% (8/32)], PDW [(14.52±4.11)% vs. (10.78±3.67)%, (11.34±3.89)%] in severe group were higher than those in light group and moderate groups (all P < 0.05), and the rate of good prognosis was significantly lower than those in mild and moderate groups [42.86% (9/21) vs. 70.83% (17/24), 71.88% (23/32), P < 0.05]. The incidence of HT in severe group was also significantly higher than those in the non-hemorrhage group [71.43% (15/21) vs. 11.76% (4/34), P < 0.05]. Conclusion SWI combined with PDW can guide the intravenous thrombolysis very well for patients with ACI, and has relatively high clinical value.