束臂试验在超声诊断锁骨下动脉盗血中的应用价值

Application value of beam arm test in diagnosis of subclavian steal

目的探讨束臂试验在多普勒超声诊断症状性锁骨下动脉盗血中的应用价值。方法选择2014年8月~2017年1月在中国中医科学院广安门医院经数字减影血管造影(DSA)、磁共振血管成像(MRA)或计算机断层扫描血管成像(CTA)证实的锁骨下动脉狭窄患者共62例,分别进行双侧锁骨下动脉及椎动脉血流方向、速度及椎动脉血流阻力指数的测量,并在束臂试验后观察频谱形态的变化。结果完全型盗血20例,部分型盗血18例,隐匿型盗血20例,无明显盗血4例;采用束臂试验后17例隐匿型盗血图像转化为部分型盗血。结论超声能够通过椎动脉血流方向及血流频谱形态变化准确诊断锁骨下动脉狭窄程度;束臂试验对超声诊断是有益的补充。

Objective To evaluate the value of beam arm test in the diagnosis of symptomatic subclavian steal by Doppler ultrasound. Methods From August 2014 and January 2017, in China Academy of Chinese Medical Sciences Guang＇anmen Hospital, 62 patients confirmed subclavian artery stenosis by digital subtraction angiography （DSA）, magnetic resonance angiography （MRA） or computer tomography angiography （CTA） were selected,the direction, velocity of bilateral subclavian artery and vertebral artery the resistance index of vertebral artery were measured, the changes of spectrum shape were observed after beam arm test. Results There were totally 20 cases were steal blood,18 eases were partial steal in blood, 20 cases were occult steal in blood, and 4 cases were no obvious steal blood; 17 cases of occult steal images were converted into partial steal after brachial beam test. Conclusion Ultrasound can accurately diagnose the degree of subclavian artery stenosis by observing the direction of vertebral artery blood flow and the characteristics of blood flow spectrum; beam arm test is a useful supplement to ultrasonic diagnosis.