彩色多普勒超声在锁骨下动脉盗血综合征诊断中的应用  

Application of Color Doppler Flow Imaging in Diagnosis of Subclavian Steal Syndrome

作　　者：张云山[1] 贺声[1] 朱世华[1] 孙鲲[1] 辛红[1] 程琳[1] 沈燕华[1] 贾文凯[1] 

机构地区：[1]海军总医院超声诊断科,北京100037

出　　处：《海军总医院学报》2004年第2期89-92,共4页Journal of Naval General Hospital of PLA

摘　　要：目的　分析比较 11例锁骨下动脉盗血综合征患者锁骨下动脉、椎动脉和桡动脉的血流动力学、频谱特点 ,以及狭窄程度与盗血的关系等。方法　 11例患者均经临床检查、超声诊断以及相关检查确诊。彩色多普勒超声常规显示颈动脉、椎动脉、桡动脉、锁骨下动脉及无名动脉的内径、内膜和血流方向及速度。结果11例患者中 ,锁骨下动脉狭窄 7例 ,内径 1 0～ 4 4mm ,血流速度 10 0～ 4 2 0cm/s ;4例锁骨下动脉闭塞 ,均引起完全性盗血。椎动脉及桡动脉峰值血流速度患侧明显低于健侧 ,患侧椎动脉出现反向血流 ,桡动脉血流与锁骨下动脉狭窄程度和反向椎动脉血流有一定关系。结论　彩色多普勒血流显像可对完全性动脉盗血综合征做出诊断 ,部分性动脉盗血综合征可辅助于脉冲多普勒和束臂试验明确诊断。完全性和部分性盗血与血管狭窄程度有关。患侧椎动脉反向血流和桡动脉峰值血流速度取决于侧支循环建立的完善与否。Objective To analyze the hemodynamics and spectral characteristics of the subclavian, vertebral and radialis artery, and the relationship between the severity of stenosis and the steal degree in 11 patients with subclavian steal syndrome (SSS) by color Doppler flow imaging (CDFI). Methods Eleven patients were diagnosed as SSS by clinic, CDFI and related physical examinations. The inside diameter and intima-media of carotid, vertebral, radialis, subclavian and innominate arteries were displayed with two-dimensional ultrasonography, and their blood flow velocity and direction were detected by CDFI. Results In the 11 patients with SSS, 7 patients had subclavian arterial stenosis with the inside diameter 1.0~4.4 mm and the velocity 100~420 cm/s. Occlusion of subclavian or innominate arterries occurred in 4 patients and caused a full SSS. The peak flow velocity of ipsilateral vertebral and radialis artery decreased significantly compared with the contralateral vertebral and radialis artery, and retrograde vertebral flow was also detected. There was a obviously relation between radialis artery flow and the severity of subclavian arterial stenosis as well as reverse vertebral flow in SSS. Conclusion The full SSS could be diagnosed by CDFI. Combining the CDFI and pulsed Doppler with tourniquet test, the partial SSS could be diagnosed. The full or partial SSS was dependent on the severity of stenosis. The peak flow of ipsilateral vertebral artery and raddialis artery was determined by cullateral circulation.

关 键 词：锁骨下动脉盗血综合征 彩色多普勒血流显像 锁骨下动脉 椎动脉 桡动脉 

分 类 号：R543.5[医药卫生—心血管疾病] R445.1[医药卫生—内科学]