锁骨下动脉盗血综合征52例超声表现分析

The misdiagnosis analysis and ultrasonic appearance of Subclavian Steal Syndrome 52cases report

目的:探讨锁骨下动脉盗血综合征(SSS)患者病因、二维及多普勒超声表现。方法:回顾性分析经超声检查并经临床及相关检查确诊的SSS患者52例的临床资料。结果:动脉硬化和大动脉炎是SSS主要病因。根据VA频谱形态划分为Ⅳ型,狭窄程度与盗血类型有对应关系。血管狭窄处内径中度≤4mm,重度≤3mm;狭窄处血流呈"五色镶嵌"样,速度>140cm/s;部分性与完全性盗血键侧VA峰值血流速度明显高于患侧(92.5±21.7)cm/s,(53.9±15.4)cm/s(P<0.001);完全性与部分性盗血键侧VA峰值血流速度有差异(98.7±24.5)cm/s,(70.6±8.9)cm/s(P<0.05)。结论:VA反向血流是SSS的重要诊断依据。超声对SSS病因诊断率高。部分性与完全性盗血与血管狭窄程度呈正相关。注重盗血Ⅰ期VA频谱改变,有助于早期诊断SSS。无盗血型见于病变复杂病情严重者。对疑诊SSS患者可行患侧上肢运动试验。

Objective：To analysis and discuss the relationship of etiopathogenisis 2-dimensional Doppler ultrasound appearance and misdiagnosis of 52 Subclvaian Steal Syndrome（SSS） cases.Methods：Retrospective analysis 52 patients who was definited to diagnosis with SSS by clinic appearance and other related inspection in our hospital.Results：The chief cause of SSS were angiosclerosis and aorto-arteritis.It can be divided into 4 groups based on Vertebral Arter（VA） spectra-morphous.The degree of narrowness correspond to the type of steal syndrome.The inside diameter of midrange narrowness was ≤4mm and next level was ≤3mm.The blood in stegnosis flows just like ＂mosaic jet ＂ and the speed was 140cm/s.The VA peak value of partly or totally steal of SSS in uninjured side was significant higher than that in injury side（92.5±21.7）cm/s vs.（53.9±15.4）cm/s,P0.001.And the VA peak value was significant difference between partly or totally steal of SSS（98.7±24.5）cm/s vs.（70.6±8.9）cm/s,P0.05.Conclusion：Backward blood of VA is of great importance in diagnosis SSS.Ultrasound have a high etiological diagnosis rate to SSS.Partly and totally steal of SSS have a positive correlation to the narrowness of blood vessel.It is conduced to early diagnosis of SSS by paying attention to its spectra alteration of stageⅠ.What＇s more no steal kind of SSS is easy to see in the patient who have a complicated and severe disease.Anyone who suspect to have a SSS can be inspected by upper extremity exercise test of injury side.