Objective  To study the relationship between CT perfusion imaging and hemorrhagic transformation after acute ischemic stroke. Methods 79 patients with acute ischemic stroke were enrolled in our hospital from December 2012 to January 2017. All patients within 12 hours（before any treatment）underwent multimode CT examination after the onset of stroke including NCCT，CT angiography, and CT perfusion. The infarct core volume, the ischemic penumbra volume，the ischemic volume,and MISMATCH RATIO (ischemic volume/infarct core volume) were calculated in all patients with CT perfusion imaging. According to the review of CT or MR images to determine whether the patient had bleeding, it was divided into hemorrhagic transformation (HT) group and non hemorrhagic transformation (non-HT) group.Univariate analysis and multivariate logistic regression analysis were used to compare the differences between the two groups in the clinical data, the volume of infarct volume and the volume of ischemic penumbra, and the relationship between the two groups. Results  Among the 79 patients with acute ischemic stroke, there were 11 cases of hemorrhagic transformation and 68 cases had no hemorrhagic transformation. 26 patients underwent intravenous thrombolytic therapy.Univariate analysis showed a significant difference between HT and non-HT groups at age, NIHSS score , onset to CTP interval ,intravenous thrombolysis. Age, ischemic penumbra volume were independent risk factors for hemorrhagic transformation, with age ischemic penumbra volume increased, the risk of hemorrhagic transformation increased. Conclusion CT perfusion imaging can predict the risk of hemorrhagic stroke in acute ischemic stroke, especially in the prevention of thrombotic transformation before thrombolytic or endovascular treatment, and can guide thrombolysis and intravascular therapy.

The relationship between CT perfusion imaging and hemorrhagic transformation after acute ischemic stroke