迷走右锁骨下动脉起始部狭窄伴右椎动脉发育不良致锁骨下动脉盗血综合征1例
Chinese Journal of Medical Imaging Technology（2023）
Abstract
患者女,51岁,因阴道不规则出血2天就诊,追溯病史发现偶感头晕1年,外院超声提示"右锁骨下动脉及右椎动脉(vertebral artery,VA)异常".查体:左上肢血压125/76 mmHg,右上肢血压95/67 mmHg,右上肢脉搏减弱.实验室检查及心电图检查未见异常.颈部血管及上肢血管彩色多普勒超声:右锁骨下动脉远心段血流频谱呈小慢波,峰值流速42 cm/s(图 1A),右 VA 内径(2.5 mm)相比左 VA(4.0 mm)窄细(图1B),收缩晚期右VA颅内、外段见反向血流信号,呈不完全锁骨下动脉盗血改变(图1C);右肱动脉峰值流速(55 cm/s)较左肱动脉(106 cm/s)显著减低(图1D);超声诊断:右锁骨下动脉起始段狭窄伴右VA发育不良(vertebral artery hypoplasia,VAH).
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