Journal of Ultrasound in Medicine, Vol 12, Issue 12 713-718, Copyright © 1993 by American Institute of Ultrasound in Medicine
Diagnosis of subclavian steal in infants with coarctation of the aorta and interruption of the aortic arch by color-coded Doppler sonography
K. H. Deeg, M. Hofbeck and H. Singer
Pediatric Clinic, Bamberg, Germany.
We report the noninvasive diagnosis of subclavian steal by color-coded
Doppler ultrasonography in nine infants with congenital heart disease. The
underlying cardiovascular malformations included coarctation of the aorta
in four infants, interrupted aortic arch type B in three patients, truncus
arteriosus communis type A4 (one patient), and isolation of the right
subclavian artery (one patient). In all patients both vertebral arteries
could be displayed through the anterior fontanel in coronal sections.
Normally the flow in both vertebral arteries, as well as the flow in the
basilar artery, is displayed in red. In eight patients with
angiographically proved unilateral subclavian steal, an antegrade (red)
flow could be shown in one vertebral artery, whereas the contralateral
vertebral artery was displayed blue, indicating reverse flow. In one infant
with interrupted aortic arch type B and associated aberrant right
subclavian artery, both vertebral arteries and the basilar artery were
displayed blue, indicating bilateral subclavian steal. Color-coded Doppler
sonography seems to be a sensitive, noninvasive method for diagnosing
congenital subclavian steal, especially in infants with obstruction of the
aortic arch.
