椎动脉颅内段盗血样频谱的分析与诊断

Analysis and diagnosis of steal spectrum in intracranial vertebral artery

①目的分析椎动脉颅内段盗血样频谱的类型与其病变部位的关系。②方法对93例采用经颅多普勒(TCD)发现一侧椎动脉出现盗血样频谱(包括血流完全逆转、收缩期大部分血流逆转、收缩早期切迹或微弱的逆转血流)的患者进行血管彩色多普勒(CDFI)或数字减影血管造影(DSA)检查,以明确病变部位。③结果 93例患者中,88例锁骨下动脉存在不同程度的病变,其中2例合并同侧椎动脉起始部轻-中度狭窄;其余5例为该侧椎动脉起始部重度狭窄或闭塞。④结论椎动脉颅内段盗血样频谱不仅见于同侧锁骨下动脉盗血综合征(SSS),还可以出现在椎动脉起始部严重病变的病例中。当TCD发现一侧椎动脉出现盗血样频谱时,不要急于作出SSS的诊断,需结合其盗血样频谱的类型进行判断,同时行CDFI或DSA检查明确。

Objective To analyze the relationship between the steal spectrum of intracranial vertebral artery and their diseased regions. Methods Steal spectrum in intracranial vertebral artery on TCD in 93 cases were found. Digital subtract angiography（DSA） or color doppler flow imaging were performed to confirm their diseased regions. Results CDFI or DSA showed 88 cases with pathological changes of different extent of subclavian artery, of which 2 cases were complicated with slightly or moderate stenosis of the vertebral artery proximal ：part; and the other 5 cases with severe stenosis or occlusion of the vertebral artery proximal part. Conclusion Steal spectrums of intracranial vertebral artery were not only found in the subclavian steal syndrome, but also were found in the vertebral artery proximal part with severe stenosis or occlusion. When the steal spectrum of intracranial vertebral artery appears, not only the type of steal spectrum, but also the CDFI and DSA were necessary for diagnosis.