彩色多普勒超声对锁骨下动脉窃血综合征颅内外动脉侧支循环和血供的研究  

Investigation of Intracranial,Extracranial and Upper Extremity Arterial Collateral Pathways and Hemodynamics in Patients with Subclavian Steal Syndrome Using Color Doppler Ultrasonography

作　　者：柳标[1] 赵宝珍[1] 姥义[1] 蒋栋[1] 

机构地区：[1]解放军第二军医大学长海医院超声科,上海市200433

出　　处：《中国超声医学杂志》2006年第8期583-585,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助项目(No.30370401)

摘　　要：目的探讨中度以上狭窄锁骨下动脉窃血综合征(SSS)颅内外动脉血流动力学的变化。方法选择正常成人及中度以上狭窄的SSS患者各15例,应用彩色多普勒超声分别观察其颅内动脉[椎动脉(VA)、基底动脉(BA)、大脑后动脉(PCA)]和颅外动脉[椎动脉(VA)、肢体桡动脉(RA)]的彩色血流方向,并测量血流动力学参数。结果(1)10例患侧颅内外VA双向血流(其中包括6例BA双向血流),5例患侧颅内外VA反向血流(其中包括2例PCA的P1段和BA反向血流),15例患者患侧RA均为单相血流(正常舒张早期为负向);(2)健侧颅内外段VA、RA较患侧平均流速增快且有明显差异(P<0.05),而与正常人比较流速稍快但无明显差异(P>0.05);患侧BA较正常人流速降低且有明显差异(P<0.05)。结论彩色多普勒超声能准确、实时评价SSS颅内外动脉的侧支循环方式及血供状况。Objective To observe the hemodynamic changes of the intracranial, extracranial and upper extremity arteries in patients with subclavian steal syndrome （SSS） in moderate artery stenosis. Methods A total of, 15 patients with SSS and 15 normal subjects （control group） were selected. Their intracranial and extracranial arterial blood flow direction was observed, and the parameters of hemodynamics were measured with color Doppler ultrasonography. Results （1） Of the 15 cases, bidirectional blood flow of the involved vertebral artery （VA） in 10 patients （including basilar artery （BA） in 6 patients）, reversed blood flow of involved VA in 5 patients （including P1 segement of posterior cerebral artery （PCA） and BA in 2）, and mono-directional blood flow of involved radial artery （RA） of the forearm in all patients were detected; （2） Mean flow velocity of contralateral VA and RA was obviously higher than the stenostic VA and RA （P〈0.05）, and slightly higher than those of the normal subjects with no significant difference （P〉0. 05） . However, flows in diseased BA was evidently lower than those in normal subjects （P 〈 0.05） . Conclusions Color Doppler ultrasonography can real-time detect the intracranial and extracranial arterial collateral pathways and the hemodynamic changes in patients with SSS.

关 键 词：彩色多普勒超声 锁骨下动脉窃血综合征 血流动力学 

分 类 号：R445.1[医药卫生—影像医学与核医学]