经颅多普勒结合颈动脉超声诊断锁骨下动脉盗血综合征的价值  

Diagnostic Value of TCD Combined with Carotid Ultrasound in Subclavian Steal Syndrome

作　　者：李婷 董亮艳[2] 孙广宏[1] 余敏[1] LI Ting;DONG Liangyan;SUN Guanghong;YU Min(Functional Department of Nerve Electrophysiology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750001,China;Department of Neuroelectrics,Cardio Cerebrovascular Hospital,General Hospital of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏回族自治区人民医院功能科神经电生理室,银川750001 [2]宁夏医科大学总医院心脑血管医院神经电生理科,银川750001

出　　处：《宁夏医科大学学报》2021年第11期1198-1201,共4页Journal of Ningxia Medical University

摘　　要：目的探讨锁骨下动脉盗血综合征(subclavian steal syndrome,SSS)经颅多普勒(transcranial dopple,TCD)结合颈动脉超声(color doppler fiow imaging,CDFI)的诊断价值。方法选取2015年6月至2018年12月宁夏回族自治区人民医院经TCD检测证实为椎动脉颅内段盗血样频谱的48例患者为研究对象,进行颈动脉彩超及256层螺旋CT血管成像(spiral CT angiography,CTA)检测,明确椎动脉颅内段盗血样频谱的原因。结果48例患者TCD结果显示:Ⅰ期盗血(椎动脉收缩期切迹)19例;Ⅱ期盗血(收缩期血流反向)23例;Ⅲ期盗血(血流完全反向)6例;CDFI结果显示:锁骨下动脉Ⅰ期盗血16例;Ⅱ期盗血23例;Ⅲ期盗血9例。锁骨下动脉轻度狭窄7例;中度狭窄10例;重度狭窄或闭塞21例;椎动脉发育异常或起始段狭窄10例。CTA结果:锁骨下动脉轻度狭窄9例;中度狭窄8例;重度狭窄或闭塞21例;椎动脉发育异常或起始段狭窄10例。CDFI与CTA两种检测方式在SubA狭窄及椎动脉病变检出情况相比差异无统计学意义(P>0.05)。结论TCD可早期发现椎动脉颅内段盗血样频谱,结合颈动脉彩超对SSS诊断具有参考价值。Objective To investigate the diagnostic value of transcranial doppler(TCD)combined with the color doppler flow imaging(CDFI)in the frequency spectrum of intracranial steal of vertebral artery,which is an early screening method for subclavian steal syndrome(SSS).Methods From June 2015 to December 2018,48 patients with intracranial vertebral artery steal spectrum confirmed by TCD were examined by carotid artery color Doppler ultrasound and 256-slice spiral CT angiography(CTA)to determine the causes of intracranial vertebral artery steal spectrum.Results The results of TCD in 48 patients showed that there were 19 cases of stage I steal(vertebral artery systolic notch),23 cases of stageⅡsteal(reverse systolic blood flow),6 cases of stageⅢsteal(complete reverse flow of blood flow).Carotid artery ultrasound results were 16 cases of subclavian artery phase I stealing;23 cases of subclavian artery phaseⅡstealing;9 cases of subclavian artery phaseⅢstealing;Subclavian artery mild stenosis in 7 cases;Subclavian artery moderate stenosis in 10 cases;Subclavian artery severe stenosis or occlusion in 21 cases;Vertebral artery dysplasia or initial segment stenosis in 10 cases.CTA results showed that 9 cases had mild subclavian artery stenosis,8 cases had moderate subclavian artery stenosis,21 cases had severe subclavian artery stenosis or occlusion,and 10 cases had abnormal vertebral artery development or initial segment stenosis.There was no significant difference between the two groups(P>0.05).Conclusion TCD can early detect the spectrum of steal blood samples in the intracranial segment of vertebral artery.Combined with carotid color Doppler ultrasound,it has reference value in the diagnosis of subclavian steal syndrome.

关 键 词：经颅多普勒 颈动脉超声 锁骨下动脉盗血综合征 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]