■本研究旨在评估彩色多普勒超声对伴有非复发性右喉神经(NRLN)的异常右锁骨下动脉(ARSA)的诊断价值。
■在本研究中,超声诊断为58例ARSA患者(ARSA组)和1,280例无ARSA患者(对照组)。此外,32例ARSA(ARSA手术组)和对照组患者接受了甲状腺切除术,手术探查有无NRLN。然后,分析NRLN的发生率。超声观察右颈总动脉(RCCA)和右锁骨下动脉(RSA)的变化趋势,分为两种类型:起源于无名动脉(IA)的RCCA和RSA(I型),和IA无法检测(II型)。
■ARSA手术组共发现32例NRLN,但在对照组没有发现病例,差异有统计学意义(p=0.0006)。在ARSA组和对照组之间,I型和II型的构成比差异具有统计学意义(p=0.0002)。也就是说,在ARSA组中无法检测到IA,伴随着起源于主动脉弓的RCCA,而对照组大多数患者在胸锁关节水平检测到IA。
■右锁骨下动脉异常可以通过超声快速检测到。在检测过程中,当RCCA起源于主动脉弓时,会发生右锁骨下动脉异常。ARSA患者有时合并有NRLN。因此,手术期间需要警惕保护NRLN。
UNASSIGNED: 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).
UNASSIGNED: 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).
UNASSIGNED: 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 (p = 0.0006). The difference in the constituent ratio of type I and type II was statistically significant between the ARSA group and controls (p = 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.
UNASSIGNED: 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.