锁骨下动脉盗血综合征的影像学诊断  

Imaging Diagnosis of Subclavian Steal Syndrome

作　　者：诸静其[1] 郝楠馨[1] 张蕾[1] 宋树良[2] 赵江民[1] 周国兴[1] 汪波[1] 王轶彬[1] 潘海虹[1] 

机构地区：[1]同济大学附属东方医院放射科 [2]同济大学附属东方医院超声科

出　　处：《中国医学计算机成像杂志》2011年第3期217-221,共5页Chinese Computed Medical Imaging

基　　金：浦东新区卫生系统医学领先人才培养项目(PWRq2008-14)~~

摘　　要：目的:回顾性分析锁骨下动脉盗血综合征的彩色多普勒超声、CTA和CE-MRA的影像表现及其诊断价值。方法:32例锁骨下动脉盗血综合征,定性诊断依据为彩色多普勒超声显示椎动脉反流并结合临床表现,均为单侧盗血。全部病例有完整的彩色多普勒声像图,14例完成CTA检查,其余18例完成CE-MRA检查,回顾性分析所有数据。结果:彩色多普勒超声显示的椎动脉反流中,24例为患侧椎动脉收缩期反流,8例为患侧椎动脉全心动周期反流,超声显示无名动脉或锁骨下动脉近端困难,所有病例均未明确盗血病因。CTA显示13例(13/14)锁骨下动脉近端中-重度狭窄,1例动脉变异。CE-MRA显示全部18例患侧锁骨下动脉近端重度狭窄,其中1例为大动脉炎所致广泛性动脉狭窄,1例双侧锁骨下动脉狭窄。结论:彩色多普勒超声可以诊断锁骨下动脉盗血综合征,但确定病因困难,CTA或CE-MRA均可以可靠确定病因,两者联合可以更加全面地诊断锁骨下动脉盗血综合征。Purpose： To evaluate the imaging manifestations and diagnosis value of color Doppler ultra- sound, CT angiography （CTA） and contrast enhancement MR angiography （CE - MRA ） in subclavian steal syndrome （SSS）. Methods： Thirty - two SSS cases whose diagnosis were made based on retrograde flow in vertebral artery on color Doppler ultrasound images and clinical manifestations were enrolled in our study.Fourteen cases were examed with CTA, other 18 cases were examed with CE - MRA.The imaging manifestations of all cases of SSS were analyzed. Results： Retrograde flow in vertebral artery was demonstrated during systole and antegrade flow during diastole in 24 cases. Retrograde flow in ver- tebral artery was demonstrated during both systole and diastole in 8 cases. But it was difficult to demonstrate the initial segment of anonyma and subclavian artery by color Doppler ultrasound. Fourteen cases were examined with CTA which indicated the presence of artery variation in 1 case and moderate or severe stenosis of the initial segment of subclavian artery in 13 cases. Other 18 cases were examined with CE - MRA which indicated severe stenosis of the initial segment of subclavian artery including a case with Takayasu arteritis and a case with stenosis of the initial segment of bilateral subclavian arter- ies. Conclusion： SSS could be diagnosed by color Doppler ultrasound, but it is difficult to define the eti- ology. Both CTA and CE - MRA could define the etiology reliably. The application of combination of color Doppler ultrasound and CTA or CE - MRA could diagnose SSS more completely.

关 键 词：锁骨下动脉盗血综合征 彩色多普勒超声 螺旋CT 磁共振成像 血管造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.5[医药卫生—诊断学]