锁骨下动脉蹼样改变的超声图像特征分析

Ultrasonographic characteristics of subclavian artery webbed changes

目的总结锁骨下动脉蹼样改变(即锁骨下动脉有向其管腔内突出膜样结构)的彩色多普勒超声图像特征。方法收集我院经颈部血管超声检查提示锁骨下动脉蹼样改变的患者213例,观察锁骨下动脉蹼样改变发生的位置、长度、厚度、突向管腔内膜样结构中膜的长轴与锁骨下动脉长轴形成的夹角,以及蹼样改变对应部位有无斑块及是否造成管腔狭窄、盗血及其程度,总结锁骨下动脉蹼样改变的超声特征。结果213例患者共发现217处锁骨下动脉蹼样改变,其中发生于右侧195处(89.9%),左侧22处(10.1%);蹼样改变长度1.2~8.6 mm,厚度0.5~1.9 mm。突向管腔内膜样结构中膜的长轴与锁骨下动脉长轴形成的夹角中,直角17个、钝角181个、平角19个。蹼样改变对应部位不伴有斑块97处,伴有斑块120处。蹼样改变造成管腔轻度狭窄58处,中度狭窄3处;蹼样改变与斑块共同造成管腔轻度狭窄65处,中度狭窄11处,重度狭窄2处;78处无管腔狭窄。蹼样改变造成隐匿盗血15处,部分盗血6处;196处无盗血。结论锁骨下动脉蹼样改变的超声表现具有一定的特征性,彩色多普勒超声可作为锁骨下动脉蹼样改变筛查的首选方法。

Objective To summarize the color Doppler ultrasonographic characteristics of subclavian artery webbed changes(that is the subclavian artery has a membranous structure protruding into its lumen).Methods A total of 213 patients with the subclavian artery webbed changes in our hospital were enrolled.The location,length,thickness of the webbed changes of the subclavian artery,the angle between the long axis of the membrane protruding into the intimal structure of the subclavian artery and the long axis of the subclavian artery,the presence of plaque at the corresponding site of the webbed changes,lumen stenosis,blood steal and its degree were observed.The ultrasonographic characteristics of the webbed changes of the subclavian artery were summarized.Results There were 217 subclavian artery webbed changes in 213 patients,195(89.9%)on the right side and 22(10.1%)on the left side.The webbed changes length was 1.2~8.6 mm and the thickness was 0.5~1.9 mm.There were 17 right angles,181 obtuse angles and 19 straight angles between the long axis of the membrane protruding into the intimal structure of the subclavian artery and the long axis of subclavian artery.There were 97 without plaque,120 with plaque in the corresponding sites of webbed changes.58 mild stenosis and 3 moderate stenosis were caused by webbed changes.The combination of plaque and webbed changes resulted in 65 mild stenosis,11 moderate stenosis,2 severe stenosis,and were 78 without stenosis.15 with concealed steal,6 with partial steal,196 without steal were caused by webbed changes.Conclusion The ultrasonographic manifestations of subclavian artery webbed changes have certain characteristics.Color Doppler ultrasonography can be used as the first choice for screening subclavian artery webbed changes.