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目的探讨经颅多普勒超声(TCD)诊断锁骨下动脉盗血综合征(SSS)的临床应用价值及与数字减影血管造影(DSA)检查的关系。方法回顾性分析79例TCD诊断为SSS患者的临床、超声影像学资料,其中37例患者另行DSA检查,对比分析TCD与DSA的检查结果。结果 79例SSS患者中Ⅰ期盗血23例(29.1%),Ⅱ期盗血36例(45.6%),Ⅲ期盗血20例(25.3%);37例SSS患者行DSA检查结果显示锁骨下动脉(Sub A)轻度狭窄4例(10.8%),中度狭窄13例(35.1%),重度狭窄14例(37.8%),闭塞6例(16.2%)。TCD检查发现的盗血程度与DSA检查所示的Sub A狭窄程度呈正相关(r=0.81,P<0.001)。结论 TCD是诊断SSS无创、敏感的首选检查方法,可为临床早期诊断和治疗提供了可靠的依据。
Objective To investigate the clinical value of transcranial Doppler ultrasound (TCD) in the diagnosis of subclavian steal syndrome (SSS) and its relationship with digital subtraction angiography (DSA). Methods The clinical and ultrasonographic data of 79 patients diagnosed as SSS by TCD were retrospectively analyzed. Twenty-seven patients underwent additional DSA and compared the results of TCD and DSA. Results In 79 SSS patients, 23 cases (29.1%) were stage I steal, 36 cases (45.6%) were stage II steal, and 20 (35.3%) stage steal were in stage III. The results of DSA in 37 SSS patients showed that SubA stenosis was found in 4 cases (10.8%), moderate stenosis in 13 cases (35.1%), severe stenosis in 14 cases (37.8%) and occlusion in 6 cases (16.2%). The degree of steal found on TCD was positively correlated with the degree of Sub A stenosis shown by DSA (r = 0.81, P <0.001). Conclusion TCD is the first choice of noninvasive and sensitive detection of SSS. It can provide a reliable basis for the early diagnosis and treatment of SSS.