上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1051-.doi: 10.3969/j.issn.1674-8115.2010.09.008

• 专题报道（影像医学与核医学） • 上一篇    下一篇

多发性大动脉炎颈动脉病变的超声诊断价值

吴春华, 李凤华, 杜 晶, 郭祎芬   

  1. 上海交通大学 医学院附属仁济医院超声医学科, 上海 200127
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 通讯作者: 李凤华, 电子信箱: proflifh@sina.com。
  • 作者简介:吴春华（1975—）, 女, 主治医师, 硕士生；电子信箱: tracy_wu310@sina.com。
  • 基金资助:

    上海市重点学科建设项目（S30203）

Diagnostic value of ultrasound in carotid artery involvement in Takayasu's arteritis

WU Chun-hua, LI Feng-hua, DU Jing, GUO Yi-feng   

  1. Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2010-09-25 Published:2010-09-27
  • Supported by:

    Shanghai Leading Academic Discipline Project, S30203

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摘要：

目的 总结多发性大动脉炎颈动脉病变的超声表现特点，提高其诊断价值。方法 回顾性分析25例经临床诊断为多发性大动脉炎的颈动脉超声声像图表现。用彩色多普勒超声检查患者的颈总动脉、颈内动脉和颈外动脉，观察并测量颈动脉管腔内径、内膜—中膜(IMT)厚度、彩色多普勒血流显像（CDFI）和脉冲多普勒，分析颈动脉血流变化的频谱及彩色多普勒声像图指标；鉴别颈动脉狭窄与闭塞，估测狭窄程度以及评估颈动脉闭塞的范围；并与数字减影血管造影（DSA）检查结果进行比较。结果 25例患者中共有50条颈动脉受累，其中39条（78%）颈总动脉受累，4条（8％）颈外动脉受累，7条（14％）颈内动脉受累。在39条受累的颈总动脉中，37条表现为动脉壁IMT弥漫性增厚；2例局限性增厚。1例颈总动脉内膜剥脱伴夹层动脉瘤形成，IMT厚度1.8～5.7 mm，管腔都有不同程度的狭窄和闭塞。超声检查血管狭窄或闭塞的诊断符合率与DSA结果比较差异无统计学意义（χ2=0.4224，P>0.05）。结论 应用彩色多普勒超声能显示颈动脉管壁的特征性变化，并可显示管腔内血流动力学异常，为临床提供重要的诊断信息。

关键词: 大动脉炎, 颈动脉, 内膜—中膜, 超声

Abstract:

Objective To investigate the diagnostic value of ultrasound in carotid artery involvement in Takayasu's arteritis. Methods The ultrasonographic features of carotid arteries in 25 patients clinically diagnosed as Takayasu's arteritis were retrospectively analysed. Common carotid arteries, external carotid arteries and internal carotid arteries were examined by colour doppler ultrasound to observe the distribution of carotid lesions, and the inner diameters and intima-media thickness (IMT) of carotid arteries were measured. The stenosis and obstruction of carotid arteries were differentiated, and were compared with digital subtraction angiography (DSA) findings. Results In 25 patients, 39(78%) common carotid arteries, 4(8%) external carotid arteries and 7(14%) internal carotid arteries were involved. In 39 involved common carotid arteries, diffused thickness of IMT was detected in 37 cases, and local thickness of IMT in 2 cases. There was one case of dissecting aneurysm, with IMT of 1.8 mm to 5.7 mm and different degrees of stenosis and obstruction. There was no significant difference in the diagnosis accordance rate of stenosis and obstruction between ultrasound and DSA （χ2=0.4224，P>0.05）. Conclusion Colour doppler ultrasound can demonstrate the characteristics of carotid artery wall and reveal the hemodynamic abnormalities of carotid artery, which is helpful in the diagnosis of Takayasu's arteritis.

Key words: Takayasu′s arteritis, carotid artery, intima-media, ultrasound