超声影像诊断多发性大动脉炎的价值

The Value of Ultrasound in the Diagnosis of Multi-Takayasu Arteritis

目的 :探讨多发性大动脉炎的二维及彩色多普勒超声特征 ,评价超声对受累动脉管腔狭窄程度判断的准确性。材料和方法 :回顾性分析 15例经血管造影证实的大动脉炎患者的超声影像资料 ,其中病变累及颈总动脉 2 2根 ,锁骨下动脉病变 2 0根 ,腹主动脉 5根 ,肾动脉 3根。结果 :病变段动脉内膜 中层厚度弥漫性增厚 ,回声偏低 ,管腔狭窄 ,狭窄程度为 3 0 %～ 96%。有 2根颈总动脉、4根锁骨下动脉闭塞。超声对颈总动脉狭窄或闭塞的诊断符合率为 95 .5 % ( 2 1/2 2 ) ,对锁骨下动脉狭窄或闭塞诊断符合率为 90 .0 ( 18/2 0 ) ,二者与血管造影结果无显著差异 (P >0 .0 5 )。结论 :大动脉炎声像图特征是动脉内膜 中层厚度弥漫性增厚 ,回声偏低 ,管腔狭窄或闭塞 ,应用彩色多普勒超声能准确地判定动脉狭窄程度。

Purpose: To explore the characters and the accuracy of two dimensional and color Doppler ultrasonic examination in the diagnosis of arterial stenosis in multi-Takayasu arteritis. Materials and Methods: Ultrasonic characters were retrospectively analysed in 15 cases with multi-Takayasu arteritis proved by angiography, whose lesions of stenosis were noted in 22 common carotid, 20 subclavian artery, 5 abdomial aorta and 3 renal artery. Results: The ultrasonic characters of the lesions were listed as diffused thickening of intima-media(IMT), low-echo and stenosis of the involved vessels. The extent of stenosis were 30%～96% with occlusions of artery in 2 common carotids and 4 subclavian arteries. The diagnostic accuracy of ultrasound in the diagnosis of stenosis or occlusion was 95.5%(21/22) in common carotid and 90.0%(18/20) in subclavian artery, with no significant difference compared with that of angiography (P>0.05). Conclusion: The ultrasound revealed characters of multi-Takayasu arteritis, and stenosis could be determined with color Doppler ultrasonic examination.