胡桃夹综合征的多层螺旋CT检查和应用价值

Evaluation of nutcracker syndrome by muiltislice spiral CT and clinical application

目的:探讨多层螺旋CT(MSCT)在诊断胡桃夹综合征(NCS)中的应用价值。方法:分析30例NCS患者(病例组)和120例正常人(对照组)的MSCT影像资料。观察NCS左肾静脉(LRV)的MSCT表现及伴随征象;测量病例组和对照组的肠系膜上动脉(SMA)与腹主动脉(AA)的夹角、LRV中心层面处SMA与AA之间距离、LRV在夹角受压处的截面积(S1)和近肾端最宽处的截面积(S2),并计算其比值(S2/S1),进行统计学分析。结果:病例组中2例可见左肾增大,2例左肾灌注慢,7例清晰显示侧枝循环建立,30例均可见LRV呈"漏斗样"变。两组比较各测量数据差异有统计学意义(P<0.05)。结论:MSCT检查能清晰显示LRV的形态、能精确测量各数值,直观地评估LRV的受压变窄程度,还可观察NCS的伴随征象,为诊断提供有力的证据。

Objective：To evaluate the diagnostic value of multislice spiral CT（MSCT） for nutcracker phenomenon（NCP）.Methods：MSCT of 30 patients clinically diagnosed as NCP（patient group） and 120 subjects with normal renal vessels（control group） were retrospectively analyzed.The anatomy,course and relationship to the adjacent structure of left renal vein（LRV） were observed.The angle of SMA and abdominal aorta and the distance between them at the level of LRV were studied.The cross areas（S1） of the angle of control group and posterior abdominal artery（AA）,the cross areas（S2） at the largest lumen near the renal hilar were measured and the ratio of S2/S1 was calculated.Results：In 30 patients with nutcracker syndrome,ther were 2 cases with enlargement of left kidney,2 with left kidney perfusion disorders,and 7 with enlargement of collateral veins.All of them showed funnel-like LRV.The difference of two group was significant（P〈0.05）.Conclusion：MSCT can show anatomy clearly of LRV for NCS,and detect each numerus,and evaluate the extent of narrow lumen accurately and complications,which provides strong evidence for its diagnosis.