双排螺旋CT在前胡桃夹综合征诊断中的应用价值

Application of double-row spiral CT in diagnoing nutcracker syndrome

目的:探讨双排螺旋CT在前胡桃夹综合征诊断中的应用价值。方法:回顾性分析6例经临床诊断为前胡桃夹综合征患者的双排螺旋CT影像学资料及临床资料。结果:6例前胡桃夹综合征均显示肠系膜上动脉压迫左肾静脉征象:腹主动脉与肠系膜上动脉之间夹角平均为18°;左肾静脉穿肠系膜上动脉夹角时明显受压,其前后径受压前后之比约4:1;其中2例显示左侧精索静脉扩张,1例显示左侧卵巢静脉扩张。结论:综合应用双排螺旋CT平扫、增强扫描及多种图像后处理技术能够清楚显示腹主动脉和肠系膜上动脉与受压的左肾静脉三者之间的解剖关系,并能发现增强扫描平衡期双肾实质密度差异及精索静脉或卵巢静脉曲张等表现,可作为前胡桃夹综合征确诊的一种重要手段。

Objective： To study the value of double-row spiral CT in diagnosing nutcracker syndrome. Methods： Retrospectively analyse imaging and clinical data of double-row spiral CT in 6 eases diagnosed to be nutcracker syndrome. Results： Six cases of nutcracker syndrome had shown that superior mesenteric artery oppressed left renal verin., the average angle between abdominal aorta and superior mesenteric artery was 18°, the angle became smaller when left renal vein passed through superior mesenteric artery, and proportion was 4 ： 1. There were 2 cases showed spermatic vein in the left side dilated; another one case showed that ovarian vein in the left side dilated. Conclusion： Double helical CT with or without enhancement associated with many post- processing. Techniques can display the anatomy among abdominal aorta, superior mesenteric artery, and left renal vein clearly, at the same time, discover the density differences between double kidneys, spermatic vein, and ovarian vein after enhanced scanning. It can be one of the most important methods to diagnose nutcracker syndrome.