中风与神经疾病杂志2025，Vol.42Issue(11)：968-973,6.DOI:10.19845/j.cnki.zfysjjbzz.2025.0177
以缺血性脑卒中为首发症状的大动脉炎6例颈动脉超声病变特征并文献复习
Carotid artery ultrasound features of Takayasu arteritis with ischemic stroke as the initial symptom:A report of six cases and literature review
白洋 1王旭 1刘皇亮 1娄喆 1金友贺 1王晓冰 1李潭 1马春燕1
作者信息
- 1. 中国医科大学附属第一医院心血管超声科,辽宁 沈阳 110002
- 折叠
摘要
Abstract
Objective To investigate the features of lesions on carotid artery ultrasound in Takayasu arteritis(TA)patients with ischemic stroke(IS)as the initial symptom.Methods A retrospective analysis was performed for the clini-cal data,vascular ultrasound findings,and other imaging data of six TA patients with IS as the initial symptom who were treated in The First Affiliated Hospital of China Medical University from January 2016 to December 2024,and a literature review was also performed to investigate the features of lesions on carotid artery ultrasound.Results Among the six pa-tients,there were two male patients and four female patients,with a median age of 29 years.There were four patients with an increase in erythrocyte sedimentation rate,and magnetic resonance imaging showed three cases of single-region IS and three cases of multi-region IS,with the involvement of the basal ganglia in four patients.Computed tomography angiogra-phy showed three patients with Numano type Ⅰ disease and three patients comorbid with middle cerebral artery occlusion.Among the six patients in terms of the changes on carotid artery ultrasound,four patients had significant wall thickening of the proximal common carotid artery(CCA)and intra-luminal thrombosis and occlusion on the stroke-affected side,one pa-tient had wall thickening of the proximal CCA without detectable thrombosis,and one patient had intra-luminal thrombosis and occlusion in the CCA without detectable wall thickening;one patient had thrombotic occlusion of the proximal internal carotid artery(ICA),one patient had thrombotic occlusion of the distal ICA,and four patients had collateral supply from the external carotid artery to the ICA via reversed flow.The assessment of lesion activity based on carotid ultrasound showed that five patients had active lesions in the CCA on the stroke-affected side,among whom two patients underwent contrast-enhanced ultrasound(CEUS)and were found to have grade Ⅲ enhancement.Carotid artery ultrasound follow-up showed that five patients achieved alleviation of CCA wall thickening,among whom two patients had a reduction from grade Ⅲ enhancement to grade Ⅰ enhancement,while one patient experienced progression from unilateral to bilateral CCA lesions and an increase to grade Ⅲ enhancement on follow-up CEUS.Conclusion TA with IS as the initial symp-tom mainly occurs during the active phase of the disease and demonstrates characteristic changes on carotid artery ultra-sound,and conventional vascular ultrasound and CEUS may help with disease diagnosis,activity assess-ment,and dynamic follow-up.关键词
缺血性脑卒中/大动脉炎/血管超声/超声造影Key words
Ischemic stroke/Takayasu arteri-tis/Vascular ultrasound/Contrast-enhanced ultrasound分类
医药卫生引用本文复制引用
白洋,王旭,刘皇亮,娄喆,金友贺,王晓冰,李潭,马春燕..以缺血性脑卒中为首发症状的大动脉炎6例颈动脉超声病变特征并文献复习[J].中风与神经疾病杂志,2025,42(11):968-973,6.
