探讨经颅双功能彩色多普勒超声在椎动脉病变中的诊断意义

发布时间：2018-06-01 13:58

本文选题：血管疾病 + 椎动脉　；参考：《中国临床医学影像杂志》2015年04期

【摘要】：目的 :探讨经颅双功能彩色多普勒超声(TCCS)在椎动脉病变中的诊断意义。方法 :随机选择有临床症状的患者230例,用TCCS检查颅内段椎基底动脉,检出椎动脉收缩期异常频谱者,再行颈部动脉及椎动脉颅外段的彩色多普勒超声(CDFI)检查。最后经磁共振颈部血管成像(增强)检查作为金标准进行证实。结果 :本组经TCCS检出颅内段椎动脉收缩期频谱异常10例,包括切迹样改变4例,呈双向频谱改变4例,呈单向逆转频谱改变2例;3例为椎动脉起始段动脉硬化至狭窄近闭塞,5例为椎动脉先天发育不良,2例诊断为锁骨下动脉盗血。结论:1当TCCS检出椎动脉出现特征性频谱改变时要考虑两个原因,一是锁骨下动脉盗血,二是椎动脉自身病变,此时需结合颈部动脉CDFI检查;2颈部动脉CDFI检查能进一步帮助查明病因,其诊断率与磁共振颈部血管成像(增强)有较高的一致性。说明TCCS是诊断椎动脉病变的一种经济、实用、较为可靠的方法。
[Abstract]:Objective: to investigate the diagnostic value of transcranial dual-function color Doppler ultrasound (TCCS) in vertebral artery lesions. Methods: two hundred and thirty patients with clinical symptoms were randomly selected to examine the intracranial vertebrobasilar artery by TCCS. The abnormal systolic spectrum of vertebral artery was detected, and then the cervical artery and the extracranial segment of vertebral artery were examined by color Doppler echocardiography (CDFI). Finally, magnetic resonance angiography (enhanced) of the neck was confirmed as a gold standard. Results: 10 cases of abnormal systolic spectrum of intracranial vertebral artery were detected by TCCS, including 4 cases of notch changes and 4 cases of bidirectional spectrum changes. There were 2 cases with unilateral reversal spectrum, 3 cases with arteriosclerosis from the beginning segment of vertebral artery to proximal stenosis and 5 cases with congenital dysplasia of vertebral artery. 2 cases were diagnosed as subclavian artery steal. ConclusionWhen TCCS detects characteristic spectrum changes of vertebral artery, two reasons should be considered, one is subclavian artery steal blood, the other is vertebral artery self-lesion. The combination of cervical artery CDFI and cervical artery CDFI can help to find out the cause of the disease, and the diagnostic rate is in good agreement with that of magnetic resonance angiography (enhanced). TCCS is an economical, practical and reliable method for diagnosis of vertebral artery disease.
【作者单位】：黑龙江省第二医院;
【分类号】：R445.1;R743

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