彩色双功超声诊断椎动脉型颈椎病的探讨

Experience During the Diagnosis of Vertebral Artery Cervical Spondylopathy by Color Duplex Ultrasonography

目的 进一步探讨椎动脉型颈椎病 (VACS)的超声表现。方法 对 119例VACS和 30例正常人行双功超声检查 ,观察椎动脉 (VA)的走行 ,测量其内径和血流参数。结果 本病的主要超声表现有 :①VA走行异常 ,呈弧形或“S”形弯曲 ,多见于颈 4～ 6段 ;②VA均匀性或局限性狭窄 ;③VA血流参数异常 ,主要为收缩期峰值流速 (Vmax)减慢 ,搏动指数 (PI)和阻力指数 (RI)升高 ;④VA颅内段血流异常。结论 双功超声有助于椎动脉型颈椎病的诊断 ,但由于颈 2至枕骨大孔段超声显示困难 ,对颈 2以下未发现异常 。

Objective To study the ultrasonic characteristic of vertebral artery cervical spondylopathy (VACS).Methods Color duplex Doppler ultrasonography was performed in 119 patients with VACS and 30 normal persons.Results The major shows of VACS were as follows:①Vertebral artery(VA) moved upwards as a winding or 'S'-shaped arc,mainly within 4～6 vertebra.②VA appeared even or segmental stenosis.③Hemodynamic changes of VA were the decrese of the systolic peak flow velocity and the increase of PI and RI.④The blood flow of intracranial VA was abnormal.Conclusion Color duplex Doppler ultrasound is valuable in the diagnosis of VACS.Because of the difficulty in showing the VA above vertebra 2,it is important to examine the intracranial VA when the extracranial VA of the patients who have symptoms of cervical spondylopathy is normal.