彩色多普勒血流显像经颅多普勒和数字减影血管造影对锁骨下动脉盗血综合征诊断价值.docVIP

彩色多普勒血流显像经颅多普勒和数字减影血管造影对锁骨下动脉盗血综合征诊断价值 　　[摘要] 目的 探讨彩色多普勒血流显像（CDFI）、经颅多普勒（TCD）和数字减影血管造影（DSA）对锁骨下动脉盗血综合征（SSS）的诊断价值。 方法 选取2013年1～12月间我院收治的SSS患者42例，分别对其行CDFI、TCD与DSA诊断。 结果 （1）CDFI诊断结果：17例锁骨下动脉中度狭窄、15例重度狭窄、10例动脉闭塞；32例动脉粥样硬化斑块、7例大动脉炎。（2）TCD诊断结果：Ⅰ期盗血16例，Ⅱ期20例，Ⅲ期6例。（3）DSA诊断结果：8例锁骨下动脉轻度狭窄，14例中度狭窄，12例重度狭窄，8例动脉闭塞。 结论 上述三种诊断方法对SSS均具有重要的诊断价值，临床上可将上述方法进行联合，以提高诊断准确性。但其中只有DSA诊断法可向医师提供锁骨下动脉动态血管路径图与几何数据资料，将为患者手术方案的制定提供良好的参考意见。因此，若存在条件限制，无法行三种诊断法联合诊断时，推荐对SSS患者行DSA诊断。 　　[关键词] 锁骨下动脉盗血综合征；彩色多普勒血流显像；经颅多普勒；数字减影血管造影 　　[中图分类号] R743.3 [文献标识码] B [文章编号] 1673-9701（2015）15-0115-03 　　[Abstract] Objective To explore the diagnostic value of color Doppler flow imaging （CDFI）， transcranial Doppler（TCD） and digital subtraction angiography（DSA） on subclavian steal syndrome （SSS）. Methods Atfal of 42 patients with SSS who were admitted to our hospital from January 2013 to December 2013 were selected. They were diagnosed by CDFI， TCD and DAS respectively. Results （1）CDFI diagnostic： 17 patients had moderate stenosis of subclavian artery， 15 patients had severe stenosis， and 10 patients had arterial occlusion. 32 patients had atherosclerotic plaque and 7 patients had takayasu arteritis. （2）TCD diagnostic： 16 patients had phase I steal blood， 20 patients had phase II steal blood， and 6 patients had phase III steal blood. （3）DSA diagnostic： 8 patients had mild stenosis of subclavian artery， 14 patients had moderate stenosis， 12 patients had severe stenosis， and 8 patients had arterial occlusion. Conclusion The above three diagnoses all have significant diagnostic value on SSS， and the above methods can be combined clinically so as to improve the accuracy of diagnosis. However， only DAS diagnosis is able to provide dynamic vascular path diagram of subclavian artery and geometric data for patients， and this will provide beneficial suggestions for formulating patients surgical procedures. Therefore， if conditions are limited and combined diagnosis with three diagnostic methods cannot be carried out， the cu