超声检查在颅外椎动脉夹层诊断中的优势：两例病例报告。
The advantage of ultrasonography in the diagnosis of extracranial vertebral artery dissection: Two case reports.
作者信息
Yang Lijuan, Ran Haitao
机构信息
Institute of Ultrasound Imaging, Chongqing Medical University, Chongqing, China Department of Neurology, Baotou Central Hospital, Baotou, Inner Mongolia, China Department of Ultrasonography, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
出版信息
Medicine (Baltimore). 2017 Mar;96(12):e6379. doi: 10.1097/MD.0000000000006379.
RATIONALE
With the rapid development in technology of vascular imaging, the detection of artery dissection is also gradually increasing. Cervical artery dissection, including carotid artery and vertebral artery dissection, is associated in at least 20% of young adult patients with stroke. So, the diagnosis of cervical artery has become a great challenge.
PATIENT CONCERNS
We reported 2 patients who complained of dizziness and pain, the findings of US confirmed the presence of extracranial vertebral artery dissection.
DIAGNOSES
The floating membrane in lumen and intramural hematoma were found in US, consistent with vertebral artery dissection, whereas DSA revealed no typical sign of artery dissection.
INTERVENTIONS
In order to the definite diagnosis we persuaded the patients to undergo DSA, but there was no strong evidence on the diagnosis of vertebtal artery dissection.
OUTCOMES
The patients were diagnosed of vertebral artery dissection by US.
LESSONS
US show more advantages in diagnosis of extracranial vertebral artery dissection, might even be considered as the first choice.
理论依据
随着血管成像技术的快速发展，动脉夹层的检出率也在逐渐增加。颈部动脉夹层，包括颈动脉和椎动脉夹层，在至少20%的年轻成年卒中患者中存在关联。因此，颈部动脉的诊断已成为一项巨大挑战。
患者情况
我们报告了2例主诉头晕和疼痛的患者，超声检查结果证实存在颅外椎动脉夹层。
诊断
超声检查发现管腔内有漂浮膜和壁内血肿，符合椎动脉夹层表现，而数字减影血管造影（DSA）未显示动脉夹层的典型征象。
干预措施
为明确诊断，我们说服患者接受DSA检查，但在椎动脉夹层的诊断上没有有力证据。
结果
患者经超声诊断为椎动脉夹层。
经验教训
超声在颅外椎动脉夹层的诊断中显示出更多优势，甚至可被视为首选。
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