彩色多普勒超声对锁骨下动脉盗血综合征的诊断价值

The Value of Color Doppler Ultrasonography in Diagnosis of Subclavian Steal Syndrome

目的 总结锁骨下动脉盗血综合征 (SSS)的二维与彩色及频谱多普勒的声像特点 ,评价超声诊断价值。方法 应用彩色多普勒超声检查 2 4例SSS患者的颅外椎动脉、锁骨下动脉 (SCA)、无名动脉及颅内椎动脉与基底动脉。结果 SSS的主要原因是动脉硬化与大动脉炎。在患侧椎动脉内出现逆向血流 ,完全盗血 ,收缩舒张期均为反向血流 ;部分盗血 ,收缩期逆向 ,舒张期正向或无血流信号。颅内椎基底动脉峰值流速明显增高。病变的锁骨下动脉起始部或无名动脉斑块形成或管壁增厚致管腔狭窄或闭塞。结论 彩色多普勒超声是筛选诊断SSS的经济、简便、无创、可靠的首选检查方法。

Objective To evaluate the value of two-dimensional ultrasound, color Doppler imaging and spectral Doppler in diagnosis of subclavian steal syndrome (SSS). Methods The extracranial vertebral, subclavian, innominate arteries and intracranial vertebral arteries (VA) and basilar artery (BA) in 24 patients with SSS were examined with color Doppler flow imaging. Results The result showed that main causes of SSS were atherosclerosis and aortoarteritis. The plaque formation and arterial wall thickening in the origin of subclavian or innominate arteries resulted in stenosis or occlusion of subclavian arteries. Retrograde flow in the VA was specific indication of SSS. Retrograde flow in VA demonstrated during both systole and diastole in cases with complete steal. Retrograde flow during systole and antegrade flow or no flow during diastole demonstrated in cases with partial steal. The peak flow velocity of intracranial VA and BA increased. Conclusion Being convenient, non-invasive, accurate and cheaper, color Doppler ultrasonography is considered as an initial technique in diagnosis of SSS.