经颅多普勒超声诊断锁骨下动脉盗血综合征的应用价值

The application value of transcranial doppler ultrasound diagnosis of 79 cases of the subclavian artery steal blood syndrome

目的探讨经颅多普勒超声(TCD)诊断锁骨下动脉盗血综合征(SSS)的临床应用价值及与数字减影血管造影(DSA)检查的关系。方法回顾性分析79例TCD诊断为SSS患者的临床、超声影像学资料,其中37例患者另行DSA检查,对比分析TCD与DSA的检查结果。结果 79例SSS患者中Ⅰ期盗血23例(29.1%),Ⅱ期盗血36例(45.6%),Ⅲ期盗血20例(25.3%);37例SSS患者行DSA检查结果显示锁骨下动脉(Sub A)轻度狭窄4例(10.8%),中度狭窄13例(35.1%),重度狭窄14例(37.8%),闭塞6例(16.2%)。TCD检查发现的盗血程度与DSA检查所示的Sub A狭窄程度呈正相关(r=0.81,P<0.001)。结论 TCD是诊断SSS无创、敏感的首选检查方法,可为临床早期诊断和治疗提供了可靠的依据。

Objective To evaluate and investigate the clinical value of transcranial Doppler（ TCD） in the diagnosis of subclavian steal syndrome（ SSS）,and the relationship with digital subtraction angiography（ DSA） examination. Methods The data of 79 cases with SSS were reviewed. Among them,37 patients were underwent DSA examination,the results of TCD and DSA were compared. Results Among 79 patients with SSS,there were 23 cases of phase Ⅰ subclavian steal（ 29. 1%）,36 cases of phase Ⅱ subclavian steal（ 45. 6%）,20 cases of phase Ⅲsubclavian steal（ 25. 3%）. The DSA tests of 37 SSS cases showed that,4 cases（ 10. 8%） was suffered from mild stenosis in subclavian artery（ Sub A）,13 cases with moderate stenosis（ 35. 1%）,14 cases with severe stenosis（ 37. 8%）,6 patients（ 16. 2%） with complete occlusion. There was positive correlation（ r = 0. 81,P〈0. 001）between stenosis in Sub A with DSA examination and the extend of subclavian steal with TCD examination. Conclusion TCD is a noninvasive diagnosis and sensitive screening method for SSS. It can provide a reliable avenue for early diagnosis and treatment for SSS.