超声对无名动脉重度狭窄或闭塞性疾病的诊断价值  

Diagnostic Value of Ultrasound in Severe Stenotic or Occlusive Disease of the Innominate Artery

作　　者：郑烨[1] 赵青[1] 秦淮[1] 牛宏珍[1] 田菊[1] 濮恬宁 陈洁[1] Zheng Ye;Zhao Qing;Qin Huai;Niu Hongzhen;Tian Ju;Pu Tianning;Chen Jie(Department of Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院综合超声科,北京市100029

出　　处：《中国超声医学杂志》2024年第1期22-26,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨彩色多普勒超声检查在无名动脉重度狭窄或闭塞性疾病中的诊断价值。方法 回顾性分析经数字减影血管造影(DSA)或CT血管造影CTA确诊的无名动脉重度狭窄或闭塞性疾病22例患者和锁骨下动脉近段重度狭窄或闭塞性疾病30例患者的血管超声特征,对两组患者血流参数改变发生率进行统计学分析。结果 Kappa一致性检验分析,无名动脉病变直接超声征象与DSA或CTA检查结果之间的一致性较好(Kappa值=0.794,P<0.05)。间接超声征象表现为6例右侧颈动脉出现血流信号方向异常,所有右侧颈内动脉频谱形态均有改变。右侧锁骨下动脉中3例为双向血流信号,所有右侧锁骨下动脉远段均呈单向频谱形态。右侧椎动脉窃血改变19例,椎动脉闭塞3例。无名动脉病变组与锁骨下动脉病变组在颈动脉血流方向及远段血管频谱形态改变上有统计学意义(P<0.05)。结论 出现右侧椎动脉窃血合并颈动脉和锁骨下动脉血流信号异常时,要考虑到无名动脉病变的可能,有必要近心段追踪扫查无名动脉。Objective To investigate the diagnostic value of color Doppler ultrasonography in severe stenotic or occlusive disease of the innominate artery.Methods Vascular ultrasound images of 22 patients with severe innominate artery stenosis or occlusive,which were diagnosed by digital subtraction angiography(DSA)or computed tomography angiography(CTA),and 30 patients with severe subclavian artery stenosis or occlusive were retrospectively analyzed.The incidence of changes in blood flow parameters was statistically analyzed in both groups.Results Kappa consistency test showed good consistency between direct ultrasound signs of innominate arterial lesions and the results of DSA or CTA(Kappa value=0.794,P<0.05).Indirect ultrasound signs showed abnormal flow signal direction in the right carotid artery in 6 cases,and all right internal carotid arteries had unusual spectral patterns.Three of the right subclavian arteries had bidirectional flow signals,and all distal right subclavian arteries showed a unidirectional low blunt spectral pattern.There were 19 cases of blood-stealing changes in the right vertebral artery and 3 cases of vertebral artery occlusion.There were significant differences between innominate artery lesion group and subclavian artery lesion group in the blood flow image of carotid artery and the morphological changes of distal carotid artery spectrum(P<0.05).Conclusions The possibility of innominate artery disease should be considered when right vertebral artery steal with abnormal blood flow signals of carotid artery and subclavian artery,and it is necessary to track the innominate artery in the proximal segment.

关 键 词：超声检查 无名动脉 重度狭窄 闭塞 

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]