二维及多普勒超声评估颈部动脉反流及病因学分析

Two-dimensional and Doppler ultrasound assessment of flow reversal in carotid artery

目的探讨颈部动脉血流反流时血流动力学改变及病因分析。方法经超声检查发现颈部动脉血管反流患者16例,多普勒超声判别血流反向血管并测量收缩期峰值血流速度(PSV),二维灰阶超声探查引起病变的血管结构变化。结果 12例患者因动脉粥样硬化致锁骨下动脉盗血引起椎动脉发生反流,健侧椎动脉内径及PSV均大于反流侧(P<0.01)。导致颈部动脉反流的原因并可见于大动脉炎致椎动脉反流、一侧颈总动脉及椎动脉发育不良致对侧椎动脉及锁骨下动脉反流、椎动脉闭塞后侧支循环建立致同侧局部椎间段反流、颈总动脉主干闭塞致颈外动脉反流等。结论超声能方便快捷地判断颈部动脉血流方向,依据动脉管腔内部结构变化为颈部动脉反流提供病因学诊断。

Objective To investigate the changes of hemodynamics during the flow reversal in carotid artery and to analyze the etiology of the formation. Methods A total of 16 cases of cervical arterial regurgitation was assessed by ultrasound to determine the reflux of blood vessels and measurement of peak systolic velocity (PSV). Gray-scale ultrasound imaging was performed to explore the site and etiology of the lesions. Results The diameter of the contralateral vertebral artery and PSV was greater than that of the reflux side in 12 cases of subclavian steal syndrome caused by atherosclerosis ( P <0.01). The etiology of flow reversal in carotid artery was also be seen in aortic inflammation causing vertebral artery reflux, common carotid artery and vertebral artery dysplasia causing contralateral vertebral artery and subclavian artery reflux, collateral circulation after the establishment of vertebral artery causing the same side of the intervertebral segment reflux, common carotid artery occlusion causing external carotid artery reflux. Conclusion Ultrasound can promptly determine the direction of the blood flow and etiological diagnosis based on the changes in the internal structure of the carotid artery.