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Objective: To explore the relationship of early cerebral infarction imaging change (DWI and PWI) and hemorrhagic transformation. Materials and Methods: A total of 58 patients with onset in patients with ischemic cerebral infarction within 3 days (40 male, 18 females), aged 35 to 89 years old, with an average age of 64.8 years to dizziness, limb weakness, slurred speech, etc. symptoms on admission. Less than three days in the onset brain MRI sequences including T1WI, T2WI, DWI, PWI 3D the SWAN half months after treatment, respectively Review head MRI in all patients, MRI examination of a total of 136 cases (including 21 patients, initial MR examination when line PWI check) of the 58 patients were divided into hemorrhagic transformation (HT) HT diagnostic criteria for the review of the blood signal (low signal) issued new 3D SWAN sequence infarction in patients with and without hemorrhagic transformation (NHT) group. (1) Statistics HT number of cases, image classification, the observed changes in clinical symptoms; (2) measuring the initial the DWI check infarct volume; the infarction lowest ADC value, rADC value and the mean ADC value; (3) measuring the initial PWI check around the infarct and infarct perfusion (rCBV value). And statistical analysis, measurement data were compared using t test, grade information Wilcoxon test was used factor analysis using multivariate logistic regression analysis, P lt; 0.05 difference was statistically significant. Results: 28 cases of hemorrhagic transformation (HT group) 1.58 patients without hemorrhagic transformation (NHT) were 30 images typing hemorrhagic infarction in type I (HI1) and hemorrhagic infarction type Ⅱ (HI2 ) main types of bleeding associated with clinical symptoms. 2 by statistical analysis, the minimum ADC value of infarct volume between the two groups of patients, infarction, rADC value and average ADC values ??were statistically significant. Logistic regression analysis, infarct volume, infarct lowest ADC value, rADC values ??and mean ADC values ??were associated with HT, gradually move method (forward LR) ultimately mean ADC value into the equation for the group HT independent impact factors, the mean ADC value protective factors, OR = 0.014, P = 0.002. Application of the receiver operating characteristic curve (ROC) analysis the predictive value of the HT group and the the NHT group's average ADC value, mean ADC values ??take the cut-off point ≤ 450 × 10-6mm2 / s, sensitivity (sensitivity) and specificity ( specificity) were higher, respectively, 0.833 and 0.750, ROC area under the curve 0.841,95% confidence interval 0.734 to 0.948. 4.21 cases line PWI check the patients with cerebral infarction, 11 cases of hemorrhagic transformation (HT group) No hemorrhagic transformation (NHT group) 10 cases by the statistical analysis, the HT group with NHT group infarct and around the lesion perfusion differences. HT group are significantly hypoperfusion infarction, peripheral perfusion increased (collateral circulation) the NHT group of multi-infarct perfusion mild to reduce or even increase, the surrounding perfusion may be normal or abnormal. Conclusion: cerebral infarction hemorrhagic transformation of the image typing HI1 and HI2-type common bleeding patterns and clinical symptoms; 2. Infarct volume, ADC value and perfusion status with hemorrhagic transformation, the mean ADC value independent prognostic factors for hemorrhagic transformation, HT prediction threshold value ≤ 450 × 10-6mm2 / s: 3.DWI and PWI hemorrhagic transformation of acute cerebral infarction the predicted significance: infarct volume, ADC values ??decreased degree of infarction perfusion is obviously insufficient, around the presence of collateral circulation, the risk of bleeding; infarct volume small degree of ADC values ??decline infarction perfusion slight decrease or even increase the risk of bleeding. Therefore, the risk of bleeding in patients with acute cerebral infarction, between the incidence of one to two weeks review of CT or MRI to find out whether there is any hemorrhagic transformation, timely adjustment of treatment.
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