目的 探讨脑梗死出血性转化的 CT、MRI影像特点。方法 回顾性分析2013 年6月-2016年6月我院收治的经手术病理 证实的32例脑梗死出血性患者临床资料， 均行CT及MRI检查，总结病例患者影像学 特点。结果 脑梗死出血性转化的CT影像 学特点：①梗死区域有明显斑片状高密度 影，病灶影边缘模糊；②出血量较大病灶 表现为团块状(不规则型，有典型占位表 现)；③出血量较小病灶经CT检查时常被 掩盖；④CT增强扫描病灶梗死区域内可见 脑回状、斑片状亦或团块状强化，而病灶 分为中心型(9例)、边缘型(11例)及混合 型(12例)三类。MRI影像学特点：①出血 后急性期出血灶T2像上呈低信号，稍高于 脑内血肿患者的信号；②亚急性期出血灶 影像学信号以短T1及长T2信号为主；③慢 性期血灶信号以T2像亦或梯度回波图像上 清晰可见含铁血黄素沉着形成的特征性的 低信号为主；④MRI增强扫描可见病灶梗 死区内有明显脑回状、斑片状亦或团块状 强化信号影。结论 脑梗死出血性转化患 者CT及MRI影像特点各具特异性，总结2种 影像学表现特点对治疗方案的制定提供重 要参考。

Objective To investigate the imaging features of CT and MRI in hemorrhagic transformation of cerebral infarction. Methods The clinical data of 32 patients with cerebral infarction hemorrhage confirmed by surgery and pathology in our hospital between June 2013 and June 2016 were retrospectively analyzed. All patients underwent CT and MRI examination, and the imaging features were summarized. Results CT imaging features of hemorrhagic transformation of cerebral infarction: ①there was obviously patchy and high-density shadow in infarction area, edges of lesions were blur. ②lesions with more hemorrhage were crumby (irregular, with typical space-occupying features). ③lesions with little hemorrhage was often covered when undergoing CT examination. ④CT enhanced scan of infarction area showed gyriform, patchy or nodular enhancement. The lesions were central type (9 cases), peripheral type (11 cases) and mixed type (12 cases). MRI imaging features. ①in acute phase after hemorrhage, hemorrhagic lesions showed low signal on T2, slightly higher than that in patients with intracerebral hematoma. ②in subacutephase, the main imaging signal of hemorrhagic lesions was short T1 and long T2 signal. ③in chronic phase, the main imaging signal of hemorrhagic lesions was clearly visible tipical low signal formed by hemosiderosis on T2 or gradient echo image. ④MRI enhanced scan showed that there was obvious gyriform, patchy or mass like enhancement signal in infarction area. Conclusion The CT and MRI features of hemorrhagic transformation of cerebral infarction are special. Summary of the findings of the two imaging methods can provide important reference for the development of treatment plan.