彩超对多发性大动脉炎锁骨下动脉病变的诊断价值

目的：研究多发性大动脉炎（Takayasu's arteritis,TA)锁骨下动脉病变的超声特点及彩超在该病中的诊断价值。方法：超声检查了16例TA患32支锁骨下动脉。灰阶超声观察病变分布情况，测量病变外管壁厚度。彩色血流显像及脉冲多普勒分析受累锁骨下动脉血流信号变化，观察椎动脉是否反流。结果：全部患均有锁骨下动脉受累（16／16，100％）。大部分患为双侧锁骨下动脉发病（11／16，69％）。病变处管壁常表现为长节段、弥漫性增厚。TA累及的锁骨下动脉主要出现狭窄闭塞性变化（44／47，94％），3支锁骨下动脉近段扩张（3／47，6％）。3支椎动脉血流反向，提示锁骨下动脉起始段端重度狭窄或闭塞。结论：彩超可清楚发现TA锁骨下动脉病变和判断病变程度，对TA该血管病变的诊断和随访有重要作用。

Diagnositic value of subclavian arterial lesions in Takayasu' s arteritis by color flow imaging

Objective To investigate the ultrasonographic characteristics of subclavian arteries(SA) in the patients with Takayasu's arteritis (TA) and the usefulness of color flow imaging in the diagnosis of TA. Methods Sixteen consecutive TA patients with 32 SA were examined by ultra-sonography. The thickness of involved SA and its anatomic distribution were measured on gray scale sonography. Color flow signals of involoved SA and reversed flow in the vertebral artery were datected by color flow imaging and pulsed Doppler. Results The involved SA could be seen in all the patients with TA( 16/16,100%) and bilateral SA were involved in most of the patients( 11/16,69%) .The most common character of the lesion was a long, diffuse thickening of involved arterial wall in SA. Arterial stenosis and occlusion were occured frequently in the involved SA of the patients with TA(44/47,94%) and dilation was found in the intimate part of 3 SA(3/47,6%) .Reversed flow was found in 3 vertebral arteries, which was an indicator of severe stenosis or occlusion in the origin of SA. Conclusion Color flow imaging can clearly map the vascular lesions and evaluate the extent of stenosis in SA,thus palying an important role in the diagnosis and follow- up the vascular changes of SA in TA.