172.Subclavian Steal Syndrome(锁骨下动脉窃血综合征)
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Subclavian Steal Syndrome 锁骨下动脉窃血综合征
Subclavian steal syndrome is defined as stenosis or occlusion of the subclavian artery proximal to the origin of the vertebral artery, with consequent reversal of blood flow in the vertebral artery to supply the distal subclavian artery, resulting in neurologic symptoms. This reversal of flow is said to “steal” blood from the intracranial circulation, which can cause ischemia or stroke.1 In the absence of neurologic symptoms, the constellation of findings can be called subclavian steal phenomenon.
锁骨下动脉窃血综合征即锁骨下的椎动脉起始处近心端狭窄或堵塞,引起椎动脉内血液倒流,进入患侧锁骨下动脉远心端,导致一系列神经系统缺血症状。这种血液倒流被形象的称为从颅内血液循环“窃血/盗血”,导致脑缺血或卒中。若缺乏神经系统症状,则称这一系列的发现为锁骨下动脉窃血现象。
FIGURE 96-5
Subclavian steal syndrome—contrast-enhanced MRA scan in a patient with Takayasu arteritis and lightheadedness induced by upper extremity exercise. The left subclavian artery is occluded approximately 1 cm beyond its origin (black arrow) and reconstitutes (black arrow) via the vertebral artery (white arrowhead). Note the bovine arch, in which the left common carotid artery (white arrow) arises from the brachiocephalic artery (asterisk). The brachiocephalic artery is also occluded and the subclavian artery reconstitutes (black arrowhead), presumably via the vertebral artery. The right common carotid artery does not reconstitute. The left common carotid artery serves as the sole source of blood flow to the intracranial circulation, leading to neurologic symptoms.
图96-5 SSS--该患者患有大动脉炎、上肢运动引起头晕,行对比增强MRA。左锁骨下动脉超过起始处1cm的位置阻塞(黑箭头),通过椎动脉重建通路(白箭头)。注意主动脉弓,可见左颈总动脉(白箭头)起源于头臂动脉(星号)。头臂动脉也堵塞,通过锁骨下动脉重建(黑箭头),也可能是通过椎动脉。右颈总动脉未重建。左颈总动脉是颅内血液循环的唯一来源,导致神经系统症状。
Notes:
1. subclavian [sʌb'kleɪvi:ən] adj. 锁骨下的
2. stenosis [stɪ'noʊsɪs] n. (器官) 狭窄
3. occlusion [ə'klu:ʒn] n. 堵塞; 闭塞
4. vertebral [ˈvɚtəbrəl, vɚˈtibrəl] adj. 脊椎的; 椎骨的
5. distal [ˈdɪstəl] adj. 末梢的
6. neurologic [njʊəroʊ'lɒdʒɪk] 神经病学的
7. constellation [ˌkɑ:nstəˈleɪʃn] n. 一系列(相关的想法、事物)
8. Takayasu arteritis 大动脉炎
9. lightheadedness 头晕
10. Bovine arch is the most common variant of the aortic arch and occurs when the brachiocephalic (innominate) artery shares a common origin with the left common carotid artery.
11. carotid [kə'rɒtɪd] n. 颈动脉(的)
12. brachiocephalic [breɪtʃi:oʊ'kefælɪk] n. 头臂动脉
13. subclavian [sʌb'kleɪvi:ən] adj.锁骨下的; 锁骨下动脉(或静脉)的
14.intracranial [ˌɪntrə'kreɪnɪrl] adj.头颅内的,颅骨内的
来源:每天朗读一段医学影像学英语文章
圈主
深圳市人民医院放射科副主任医师杨敏洁