彩色多普勒超声诊断颞浅动脉炎的临床价值

Clinical value of color Doppler ultrasonography for diagnosis of superficial temporal arteritis

目的探讨彩色多普勒超声(CDU)对颞浅动脉炎(STA)诊断的临床价值。方法收集2008年9月—2012年5月,威海市立医院收治的符合美国风湿病学会诊断标准的STA患者,共18例(STA组),7例行颞浅动脉组织活检检查。选取同期年龄、性别相近,非STA患者20例为对照组。通过彩色多普勒超声检查比较两组患者双侧颞浅动脉管壁回声、动脉内径、血管壁厚度、峰值流速(PSV)、舒张末期流速(EDV)、血管阻力指数(RI)、血管搏动指数(PI)的差异性。结果①18例STA患者中,16例(88.9%)患者出现CDU异常结果,其中14例(77.8%)患者出现"靶环征",1例(5.6%)出现"靶环征"合并节段性血管狭窄征,1例(5.6%)出现血管壁回声增强、管腔显示不清、无血流信号充盈的血管闭塞征。②经CDU检查,对照组患者均未出现"靶环征"和"靶环征"合并节段性血管狭窄征。1例(5.0%)患者为动脉闭塞,血管结构显示不清,与STA组闭塞患者的CDU结果相似。③STA组的颞浅动脉内径为(1.31±0.14)mm,低于对照组的(1.55±0.18)mm;STA组的管壁厚度为(0.86±0.18)mm,高于对照组的(0.34±0.06)mm,差异均有统计学意义。STA组与对照组之间的PSV、EDV、RI、PI比较,差异均无统计学意义。结论 CDU检查中出现"靶环征"、颞浅动脉内径和管壁厚度的改变有助于临床诊断STA。

Objective To investigate the clinical value of color Doppler ultrasonography（CDU） for diagnosis of superficial temporal arteritis（STA）.Methods A total of 18 patients with STA meeting the diagnostic criteria of the American College of Rheumatology admitted in Weihai Municipal Hospital from September 2008 to May 2012 were collected（STA group）.STA biopsy examination was performed in 7 patients.At the same time period,the age-and gender-matched 20 non-STA patients with headache were used as a control group.The differences of wall echo,internal diameter of artery,thickness of the vascular wall,peak systolic velocity（PSV）,end diastolic velocity（EDV）,vascular resistance index（RI）,and pulsatility index（PI） of bilateral superficial temporal artery were compared in both groups with CDU.Results ①Of the 18 patients with STA,16（88.9%） had abnormal results on CDU,14（77.8%） of them had a halo sign,1（5.6%） had a halo sign and segmental artery stenosis,1（5.6%） had vascular occlusive syndromes of increased wall echo,the vessel struture unclear and no flow signal.②The patients in the control group did not have any halo sign and halo sign combined with segmental artery stenosis.One patient（5%） had artery occlusion,his vascular structure showed unclear,which was similar to the ultrasonography of the patients with vascular occlusion in the STA group.③The internal diameter of the superficial temporal artery in the STA group was 1.31±0.14 mm,and it was lower than 1.55±0.18 mm in the control group;the vascular wall thickness was 0.86±0.18 mm in the STA group,and it was higher than 0.34±0.06 in the control group.The differences were statistically significant.There were no significant differences in PSV,EDV,RI,and PI between the STA group and the control group.Conclusion The halo sign,the changes of internal diameter and the wall thickness of superficial temporal artery may contribute to the clinical diagnosis of superficial temporal arteritis.