彩色多普勒超声和CT血管成像在颈部动脉夹层诊断中的应用
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摘要
目的比较彩色多普勒超声和CT血管成像(CTA)在颈部动脉夹层中的诊断应用。方法对数字减影血管造影(DSA)确诊的颈部动脉夹层33例患者进行常规彩色多普勒超声和CTA检查,并对2种方法进行比较。结果颈部动脉夹层发生于颈内动脉、颈总动脉与椎动脉分别为82%、15%及3%,发生于左右侧分别为39%及61%。2种检查方法在颈部动脉夹层膜状结构、真假腔显示上无明显区别,彩色多普勒超声能提供动脉血流动力学参数,但在夹层破口显示上CTA优于彩色多普勒超声,在检查能否给予明确诊断上差异无统计学意义。结论颈动脉超声与CTA 2种无创性血管检查方法相互补充。颈动脉超声在经济、方便上占有优势,可作为颈部动脉夹层最常用的首选筛查方法,为临床诊断和指导治疗提供相关信息。
Objective To observe and compare the clinical value of color Doppler ultrasonography and CT angiog raphy(CTA) used in dignosis with cervical artery dissection. Methods Color Doppler ultrasonography and CTA was performed in 33 patients who cervical artery dissection diagnosed by digital subtraction angiography(DSA). Results The cervical artery dissection were diagnosed by color doppler ultrasound in 33 patients. Of these 33 patients,82% had happen in internal carotid arteries,15% had happen in common carotid arteries,3% had happen in vertebral artery. 39%had happen in left,61% had happen in right. There was no significant difference between the two kinds of examination methods in intimal echo and true and false lumens of cervical artery dissection. Color doppler ultrasonography can provide the arterial blood flow mechanics parameters,but the CTA is better than that of color doppler ultrasound on the crevasse display,and there is no obvious difference in giving clear diagnosis. Conclusion Carotid ultrasound and CTA are complementary to the two non-invasive methods,which can improve the diagnosis rate. Carotid artery ultrasonography has the advantage in economy and convenience,which can be used as the most commonly used screening method for cervical artery interlayer,providing relevant information for clinical diagnosis and guidance therapy.
Objective To observe and compare the clinical value of color Doppler ultrasonography and CT angiog raphy(CTA) used in dignosis with cervical artery dissection. Methods Color Doppler ultrasonography and CTA was performed in 33 patients who cervical artery dissection diagnosed by digital subtraction angiography(DSA). Results The cervical artery dissection were diagnosed by color doppler ultrasound in 33 patients. Of these 33 patients,82% had happen in internal carotid arteries,15% had happen in common carotid arteries,3% had happen in vertebral artery. 39%had happen in left,61% had happen in right. There was no significant difference between the two kinds of examination methods in intimal echo and true and false lumens of cervical artery dissection. Color doppler ultrasonography can provide the arterial blood flow mechanics parameters,but the CTA is better than that of color doppler ultrasound on the crevasse display,and there is no obvious difference in giving clear diagnosis. Conclusion Carotid ultrasound and CTA are complementary to the two non-invasive methods,which can improve the diagnosis rate. Carotid artery ultrasonography has the advantage in economy and convenience,which can be used as the most commonly used screening method for cervical artery interlayer,providing relevant information for clinical diagnosis and guidance therapy.
引文
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[7]朱文晖,段星星,李瑞珍,等.增强型能量多普勒成像及超声造影对颈动脉粥样斑块的评价[J].中国超声医学杂志,2009,25(11):1048-1050.
[8]Puqliese F,Crusco F,Cardaioli G,et al.CT angiography versus colour Doppler US in acute dissection of the vertebral artery[J].Radiol Med,2007,112(3):435-443.
[9]Clever DA,Rupp N,Reiser M,et al.Improved diagnosis of vascular dissection by ultrasound B-flow:a comparison with colorcoded Doppler and power Doppler sonography[J].Eur Radiol,2005,15(2):342-347.
[10]李彤.超声造影在评价颈动脉粥样硬化斑块稳定性中的应用[J].影像研究与医学应用,2018,2(9):107-108.
[2]Taschner CA,Leclerc X,Lucas C,et al.Computed tomography angiography for the evaluation of carotid artery dissections[J].Front Neurol Neurosci,2005,20:119-28.
[3]Alecu C,Fortrat J,Ducrocq X,et al.Duplex scanning diagnosis of internal carotid artery dissections:a case control study[J].Cerebrovasc Dis,2007,23(5-6):441-447.
[4]Benninger DH,Baumgartner RW.Ultrasound diagnosis of cervical artery dissection[J].Front Neurol Neurosci,2006,21:70-84.
[5]Suzuki R,Koga M,Toyoda K,et al.Identification of internal carotid artery dissection by transoral carotid ultrasonography[J].Cerebrovasc Dis,2012,33(4):369-377.
[6]袁公贤,汪迎晖,任江华,等.超声B-flow在急性脑梗死患者颈动脉斑块新生血管检测中的应用探讨[J].中华全科医师杂志,2012,11(9):658-660.
[7]朱文晖,段星星,李瑞珍,等.增强型能量多普勒成像及超声造影对颈动脉粥样斑块的评价[J].中国超声医学杂志,2009,25(11):1048-1050.
[8]Puqliese F,Crusco F,Cardaioli G,et al.CT angiography versus colour Doppler US in acute dissection of the vertebral artery[J].Radiol Med,2007,112(3):435-443.
[9]Clever DA,Rupp N,Reiser M,et al.Improved diagnosis of vascular dissection by ultrasound B-flow:a comparison with colorcoded Doppler and power Doppler sonography[J].Eur Radiol,2005,15(2):342-347.
[10]李彤.超声造影在评价颈动脉粥样硬化斑块稳定性中的应用[J].影像研究与医学应用,2018,2(9):107-108.