陈玮,鄢磊,阮琴韵,刘新秀,庄勇,叶小剑.颈动脉夹层的超声表现及漏诊分析[J].中国医学影像技术,2019,35(11):1643~1647
颈动脉夹层的超声表现及漏诊分析
Ultrasonographic manifestations and missed diagnosis analysis of cervical artery dissection
投稿时间:2019-03-27  修订日期:2019-09-04
DOI:10.13929/j.1003-3289.201903203
中文关键词:  动脉瘤,夹层  超声检查  诊断
英文关键词:aneurysm, dissecting  ultrasonography  diagnosis
基金项目:2019年福建省卫生健康中青年骨干人才培养项目(2019-ZQN-64)、福建省科技厅引导性项目(2017Y0031)、福建医科大学启航基金(2016QH061)。
作者单位E-mail
陈玮 福建医科大学附属宁德市医院超声医学科, 福建 宁德 352000  
鄢磊 福建医科大学附属第一医院超声影像科, 福建 福州 350005 yanlei20082336@163.com 
阮琴韵 福建医科大学附属第一医院超声影像科, 福建 福州 350005  
刘新秀 福建医科大学附属第一医院超声影像科, 福建 福州 350005  
庄勇 福建医科大学附属第一医院超声影像科, 福建 福州 350005  
叶小剑 福建医科大学附属第一医院超声影像科, 福建 福州 350005  
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中文摘要:
      目的 探讨颈动脉夹层超声表现,分析超声检查的漏诊原因。方法 回顾性分析经高分辨率MRA/CTA/DSA确诊的28例颈动脉夹层的超声图像,观察颈动脉夹层的声像图特征,分析超声漏诊原因。结果 28例颈动脉夹层中,15例超声诊断明确,13例超声漏诊,诊断符合率53.57%(15/28),漏诊率46.43%(13/28)。15例颈动脉夹层的超声表现为"双腔征"7例,壁内血肿6例,闭塞或重度狭窄提示颈动脉夹层2例;15例中合并血流异常15例,合并频谱异常7例;超声漏诊13例中,6例超声阴性,7例仅提示重度狭窄或闭塞及频谱异常。结论 颈动脉夹层超声表现以"双腔征"和壁内血肿较常见。年轻且无动脉粥样硬化者,若出现颈动脉重度狭窄或闭塞以及血流动力学异常时,需高度警惕颈动脉夹层。
英文摘要:
      Objective To investigate the ultrasonographic manifestations of cervical artery dissection and analyze the causes of missed diagnosis. Methods Ultrasound images of 28 patients with cervical artery dissection diagnosed by high-resolution MRA/CTA/DSA were retrospectively analyzed, and the sonographic features of cervical artery dissection were observed, and the causes of missed ultrasound diagnosis were analyzed. Results In the 28 cases of cervical artery dissection, 15 cases were clearly diagnosed by ultrasound, 13 cases were missed diagnosis by ultrasound, the diagnostic coincidence rate was about 53.57% (15/28), and the missed diagnosis rate was 46.43% (13/28). Ultrasonographic manifestations of cervical artery dissection were in 15 cases including "double lumen sign" in 7 cases, intramural hematoma in 6 cases, occlusion or severe stenosis in 2 cases. In the 15 patients, 15 had abnormal blood flow and 7 had abnormal spectrum. In the 13 cases of missed ultrasonic diagnosis, 6 cases were negative, 7 cases only were reminded severe stenosis or occlusion and abnormal frequency spectrum. Conclusion "Double lumen sign" and intramural hematoma are common manifestations of cervical artery dissection. Young and non-atherosclerotic patients should be highly alert to cervical artery dissection in the presence of severe carotid artery stenosis or occlusion and hemodynamic abnormalities.
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