正中弓状韧带综合征患者侧支动脉与临床症状的相关性  

Correlation Between Collateral Artery and Clinical Symptoms in Patients with Median Arcuate Ligament Syndrome

作　　者：赵珊珊 王贤明 华先平 高洁 蔡丽娜 胡伟林 Zhao Shanshan;Wang Xianming;Hua Xianping;Gao Jie;Cai Li'na;Hu Weilin(Department of Ultrasound,Wuhan Wuchang Hospital(Wuchang Hospital to Wuhan University of Science and Technology),Wuhan 430063,China;Department of Ultrasound,Xiaolan Hospital Affiliated to Southern Medical University,Zhongshan,Guangdong 528415,China;Department of Cardiovascular Medicine,Xiaolan Hospital Affiliated to Southern Medical University,Zhongshan,Guangdong 528415,China;Department of Interventional Radiology,Wuhan Wuchang Hospital(Wuchang Hospital to Wuhan University of Science and Technology),Wuhan 430063,China;Department of Respiratory and Critical Care Medicine,Wuhan Wuchang Hospital(Wuchang Hospital to Wuhan University of Science and Technology),Wuhan 430063,China)

机构地区：[1]武汉市武昌医院(武汉科技大学附属武昌医院)超声科,武汉市430063 [2]南方医科大学附属小榄医院超声科,广东省中山市528415 [3]南方医科大学附属小榄医院心血管内科,广东省中山市528415 [4]武汉市武昌医院(武汉科技大学附属武昌医院)介入放射科,武汉市430063 [5]武汉市武昌医院(武汉科技大学附属武昌医院)呼吸与危重症医学科,武汉市430063

出　　处：《中国超声医学杂志》2023年第9期1018-1021,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨正中弓状韧带综合征患者的侧支动脉与临床症状之间的相关性。方法记录彩色多普勒超声考虑正中弓状韧带综合征患者的临床症状,以及肝总动脉不同呼吸状态的血流方向,并与CTA检查对比,测量侧支动脉的最大内径。使用SPSS 23.0软件对侧支动脉内径与临床症状的相关性进行分析。结果40例患者成功完成超声和CTA检查,超声检出阳性23例,阴性17例。阴性患者肝总动脉血流方向呼气和吸气状态下均为正向。阳性患者表现为呼气末肝总动脉逆向,吸气末方向恢复正常或持续逆向。CTA检出25例侧支形成,其呼气末腹腔动脉狭窄率均>70%。25例患者中,大部分患者(76%,19/25)表现出不同程度的症状,其症状的有无与侧支动脉内径呈正相关(Pearson相关系数r=0.62,P<0.01)。结论超声发现呼气状态肝总动脉逆流表明侧支形成及腹腔动脉存在重度狭窄;侧支的出现意味着严重的血流动力学改变,并与临床症状有很好的相关性,多数患者均可能出现临床症状。Objective To approach the correlation between collateral artery and clinical symptom in the patient with median arcuate ligament syndrome(MALS).Methods In the patients with MALS detected by color Doppler ultrasound(CDU),symptoms and the flow direction of common hepatic artery(CHA)on expiration were recorded,then computed tomographic angiography(CTA)was performed,and the collateral artery diameter was measured.SPSS 23.0 software was used to calculate the correlation between collateral artery diameter and clinical symptom.Results Total 40 cases were achieved by CDU,and 23 positive and 17 negative cases were revealed.In the negative group,the flow direction in CHA didn't change with respiration.In the positive group,the flow was retrograde at expiration and returned normal or remained reverse on inspiration.All the 40 cases were confirmed by CTA,2 false-negative were determined.In the 25 true-positive cases,the stenosis percentage on expiration were≥70%,and the majority of the patients(76%,19/25)were symptomatic,the symptoms closely associated with collateral artery diameter(r=0.62,P0.01).Conclusions Reverse flow in the CHA on expiration will indicate collateral artery formation and significant stenosis of celiac artery.the presence of collateral artery means severe hemodynamic changes,and closely association with clinical symptoms,the majority of patients are symptomatic.

关 键 词：彩色多普勒超声 正中弓状韧带综合征 肝总动脉 侧支动脉 CTA 

分 类 号：R445.1[医药卫生—影像医学与核医学] R572.3[医药卫生—诊断学]