2022 年第 7 期 第 17 卷

颈部血管超声联合经颅彩色多普勒超声在锁骨下动脉盗血综合征诊断中的应用价值

The value of cervical vascular ultrasonography combined with transcranial color Doppler sonography in diagnosis of subclavian steal syndrome 

作者：李亮1张蕾1濮恬宁1王明月1郑超1郑铁晋2

英文作者：Li Liang1 Zhang Lei1 Pu Tianning1 Wang Mingyue1 Zheng Chao1 Zheng Tiejin2

单位：1首都医科大学附属北京安贞医院综合超声科北京市心肺血管疾病研究所，北京100029；2首都医科大学附属北京安贞医院神经外科北京市心肺血管疾病研究所，北京100029

英文单位：1Department of General Ultrasound Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China; 2Department of Neurosurgery Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

关键词：锁骨下动脉盗血综合征；颈部血管超声；经颅彩色多普勒超声

英文关键词：Subclavianstealsyndrome;Cervicalvascularultrasound;TranscranialcolorDopplersonography

• 摘要：

• 目的 探讨颈部血管超声联合经颅彩色多普勒超声（TCCS）在锁骨下动脉盗血综合征（SSS）诊断中的应用价值。方法 收集2019年6月至2021年10月首都医科大学附属北京安贞医院收治的86例SSS患者的临床资料进行回顾性分析。分别记录颈部血管超声检查锁骨下动脉狭窄程度、颈部血管超声和TCCS检查盗血分型及盗血途径的结果，并与数字减影血管造影（DSA）检查结果对照。结果 一致性检验结果显示颈部血管超声与DSA评估锁骨下动脉狭窄程度的一致性良好（P＜0.001）。颈部血管超声检查显示颅外段椎动脉Ⅰ型盗血29例、Ⅱ型盗血33例、Ⅲ型盗血24例；TCCS检查显示颅内段椎动脉Ⅰ型盗血32例、Ⅱ型盗血34例、Ⅲ型盗血20例；DSA检查显示椎动脉Ⅰ型盗血0例、Ⅱ型盗血25例、Ⅲ型盗血24例。颈部血管超声联合TCCS检查显示健侧椎动脉向患侧椎动脉供血者86例，基底动脉向患侧椎动脉供血者10例，患侧枕动脉向患侧椎动脉供血者12例；DSA检查显示健侧椎动脉向患侧椎动脉供血者49例，基底动脉向患侧椎动脉供血者4例，患侧枕动脉向患侧椎动脉供血者14例。结论 颈部血管超声联合TCCS在SSS患者的诊断中可以为临床提供较准确的信息，特别是在病变早期，具有很高的应用价值。

• Objective To evaluate the value of cervical vascular ultrasound combined with transcranial color Doppler sonography (TCCS) in the diagnosis of subclavian steal syndrome (SSS). Methods Clinical data of 86 patients with SSS admitted to Beijing Anzhen Hospital, Capital Medical University from June 2019 to October 2021 were retrospectively analyzed. The degree of subclavian artery stenosis detected by cervical vascular ultrasound. The typing and channeling of subclavian steal detected by cervical vascular ultrasound and TCCS were recorded, and the results were compared with digital subtraction angiography (DSA). Results The conformance test showed that cervical vascular ultrasound and DSA had good consistency in assessing the degree of subclavian artery stenosis (P＜0.001). The results of typing of subclavian steal showed that under cervical vascular ultrasound, there were 29 cases of type Ⅰ, 33 cases of type Ⅱ and 24 cases of type Ⅲ in extracranial vertebral artery; under TCCS, there were 32 cases of type Ⅰ, 34 cases of type Ⅱ and 20 cases of type Ⅲ in intracranial vertebral artery; under DSA, there were none of type Ⅰ, 25 cases of type Ⅱ and 24 cases of type Ⅲ in vertebral artery. Cervical vascular ultrasound combined with TCCS showed that 86 cases were supplied by contralateral vertebral artery, 10 cases by basilar artery, and 12 cases by occipital artery to lpsilateral; DSA showed that 49 cases were supplied by contralateral vertebral artery, 4 cases by basilar artery, and 14 cases by occipital artery to lpsilateral vertebral artery. Conclusion Cervical vascular ultrasound combined with TCCS provided more accurate information for clinical diagnosis of SSS, especially in the early stage of the disease, which has a high application value.