三维对比增强磁共振血管成像诊断胡桃夹综合征

3D-CE MRA diagnosis of nutcracker syndrome

目的探讨3D-CE MRA对胡桃夹综合征(NCS)的诊断价值。方法对4例NCS患者及对照组(30名3D-CEMRA表现正常者)的3D-CE MRA原始图像进行重建,测量数据并对照分析。结果所有研究对象左肾静脉(LKV)均跨过腹主动脉前方;对照组肠系膜上动脉(SMA)与腹主动脉间夹角为(84.50±13.60)°,SMA前行(13.40±5.10)mm转而下行,经过LKV层面SMA与腹主动脉间距离为(16.40±5.10)mm,LKV肾门前段与SMA、腹主动脉夹角段前后径比值为1.4。4例NCS患者的夹角明显变小(<30°),且SMA以较小角度发出后前行较短距离后即转向下行,SMA与腹主动脉间距离变小,SMA与腹主动脉夹角内LKV明显受压,LKV扩张段与狭窄段前后径平均比值为4.5,与对照组有明显差异。结论3D-CE MRA能显示腹主动脉、SMA与LKV三者之间关系,准确诊断NCS。

Objective To assess the diagnostic value of 3D-CE MRA for nutcracker syndrome（NCS）.Methods The 3D-CE MRA appearances of 4 patients of NCS and control group（30 persons） were analyzed.Results The left kidney vein（LKV） crossed before abdominal aorta in 4 NCS patients and 30 controls.The average angle of the origin of the superior mesenteric artery（SMA） from the abdominal aorta was（84.50±13.60）° in control group,and became small（〈30°） in 4 NCS patients.The distance of the origin of the SMA to the beginning of descent was（13.40±5.10） mm,and the SMA and abdominal aorta in the axial plane crossing the LKV was（16.40±5.10） mm in controls,and all decreased in 4 NCS patients whose LKV was obviously compressed.The average ratio of expansion to stenosis caliber of the LKV was 4.5 in 4 NCS patients,whereas 1.4 in the controls.Conclusion 3D-CE MRA can display relation between abdominal aorta,SMA and LKV,thus exactly diagnose the nutcracker syndrome.