Liang Rong-Xi, Wang Bo, Zhao Wen-Xin, Xue En-Sheng, Ye Qin, Chen Zhi-Yong, Chen Zhi-Kui, Lin Xue-Ying, Lin Zhen-Hu, Lin You-Jia
Department of Ultrasound, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
Department of Vessels and Thyroid Surgery, Union Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
Arch Med Sci. 2020 Sep 14;20(3):719-725. doi: 10.5114/aoms.2020.98971. eCollection 2024.
This study aims to evaluate the predictive value of color Doppler ultrasound for the diagnosis of aberrant right subclavian artery (ARSA) with a co-occurring non-recurrent right laryngeal nerve (NRLN).
In the present study, 58 patients with ARSA (ARSA group) and 1,280 patients without ARSA (controls) were diagnosed by ultrasonography. In addition, 32 patients with ARSA (ARSA operation group) and controls underwent thyroidectomy with surgical exploration with or without NRLN. Then, the incidence of NRLN was analyzed. The right common carotid artery (RCCA) and right subclavian artery (RSA) trends were observed by ultrasound, and classified into two types: RCCA and RSA originating from the innominate artery (IA) (type I), and IA could not be detected (type II).
A total of 32 cases of NRLN were found in the ARSA operation group, but no case was found in controls, and the difference was statistically significant ( = 0.0006). The difference in the constituent ratio of type I and type II was statistically significant between the ARSA group and controls ( = 0.0002). That is, the IA could not be detected in the ARSA group, which was accompanied by the RCCA that originated from the aortic arch, while the IA was detected in most patients in the control group at the level of the sternoclavicular joints.
Aberrant right subclavian artery can be rapidly detected by ultrasonography. Aberrant right subclavian artery occurs when the RCCA originates from the aortic arch during detection. Patients with ARSA sometimes have co-occurring NRLN. Hence, vigilance in protecting the NRLN is needed during an operation.
本研究旨在评估彩色多普勒超声对诊断合并非返行性右侧喉返神经（NRLN）的迷走右锁骨下动脉（ARSA）的预测价值。
在本研究中，58例ARSA患者（ARSA组）和1280例无ARSA患者（对照组）通过超声检查进行诊断。此外，32例ARSA患者（ARSA手术组）和对照组接受了甲状腺切除术，并在手术中探查有无NRLN。然后，分析NRLN的发生率。通过超声观察右侧颈总动脉（RCCA）和右侧锁骨下动脉（RSA）的走行，并分为两种类型：RCCA和RSA起源于无名动脉（IA）（I型），以及未检测到IA（II型）。
ARSA手术组共发现32例NRLN，但对照组未发现，差异有统计学意义（P = 0.0006）。ARSA组和对照组I型和II型的构成比差异有统计学意义（P = 0.0002）。即ARSA组未检测到IA，同时伴有起源于主动脉弓的RCCA，而对照组大多数患者在胸锁关节水平检测到IA。
超声检查可快速检测出迷走右锁骨下动脉。当检测到RCCA起源于主动脉弓时，会出现迷走右锁骨下动脉。ARSA患者有时合并NRLN。因此，手术中需要警惕保护NRLN。
