彩色多普勒超声诊断先天性小儿椎动脉发育不良的应用研究

目的探讨超声检查对小儿先天性颅外段椎动脉发育不良及其血流动力学改变的诊断价值。方法 82例年龄为2.4～14岁有头痛、头晕、晕厥病史的小儿作为观察组,86例年龄为2~14岁的正常小儿作为对照组,两组小儿均经超声检查。椎动脉内径、走行、管壁形态、血流动力学参数,诸如椎动脉中间段PSV,RSV,PI,RI等是逐例测量和观察记录的。并对两组检测数据进行统计学分析与比较。结果超声检查证实,观察组82例中有6例先天性颅外段椎动脉发育不良,其发生率为7.3%。6例患儿中,5例左侧受累,1例右侧受累。患侧椎动脉内径,PSV,RSV与对照组比较,有显著性差异（P〈0.05）,但患侧PI与RI值与对照组比较,无统计学差异（P〉0.05）。患儿健侧血流动力学参数与对照组比较,亦无显著性差异（P〉0.05）。结论小儿先天性椎动脉发育不良势必会影响后循环的血供,而超声检查不仅能显示椎动脉的形态异常,同时能评价其血流动力学改变,因此,超声检查对诊断本病具有重要价值。

Applied value of ultrasonography for diagnosing congenital hypoplasia of the extracranial vertebral arteries in children

Objective To explore the applied value of ultrasonography （US） for diagnosing congenital hypoplasia of the extracranial vertebral arteries and their hemodynamic change. Methods Eighty-two pediatric patients aged 2.4-14.0 years with history of headache, vertigo and faint were taken as observation group and 86 normal children aged 2.0-14.0 years were taken as control group. All children of the two groups underwent US. The vertebrarterial diameter, path, wall shape, and hemodynamic parameters such as PSV, RSV, PI and RI in middle segments were measured, observed and recorded for each case. Subsequently, the data acquired from the both group were statistically analyzed and compared each other. Results US demonstrated that there were 6 ill children with congenital hypoplasia of extracranial vertebral arteries in 82 cases of observation group with 7.3% of the incidence. These 6 ill children comprised 5 left and 1 right involvement. The vertebrarterial diameter,PSV, RSV between affected side of ill children and control group were significant difference （P0.05） but PI and RI values between above both were not statistic difference （P 0.05）. The hemodynamic parameters between intact side of ill children and control group were not significant difference （P 0.05）. Conclusion Congenital vertebrarterial hypoplasia in children will necessitously influence on the blood-supply of posterior circulation, while US can not only show the abnormalities of vertebral artery shape but can evaluate their hemodynamic changes so that it has important value to diagnose this disease.