彩色多普勒超声诊断胡桃夹现象并左侧精索静脉曲张的价值

Diagnostic Value of Nutcracker Phenomenon Syndrome Complicated with Left Varicocele with Color Doppler Flow Imaging

目的探讨彩色多普勒超声对胡桃夹现象合并左侧精索静脉曲张诊断价值及意义。方法对12例拟诊为胡桃夹现象的患者,采用彩色多普勒超声检查测量腹主动脉和肠系膜上动脉之间的夹角、左肾静脉受压狭窄段及近肾门扩张段内径及血流峰值,测量左侧精索静脉内径及血液返流情况。结果胡桃夹现象患者其左肾静脉受压狭窄段内径较近肾门扩张段内径明显狭窄,血流峰值速度明显增快。12例患者中10例患者合并Ⅱ～Ⅲ左侧精索静脉曲张。结论彩色多普勒超声检查对于胡桃夹现象并左侧精索静脉曲张诊断无创、准确率高、可重复,应为首选检查。

Objective To summarize the diagnostic value of nutcracker phenomenon complicated with left varicocele using color Doppler flow imaging. Methods Twelve cases of nutcracker phenomenon complicated with left varicocele were examinated with color Doppler flow imaging （CDFI）. The left renal vein was measured respectively by ultrasound; the parameters included the angle between aorta and SMA, inner diameter of the left renal vein near the hilum and between aorta and SMA. The peak velocities of the corresponding portion of the left renal veins were also recorded. Results The inner diameter of the left renal vein between aorta and SMA was narrower remarkably compared with the portion near the hilum, and the peak velocities of former was faster than the later. 10 cases were complicated with left varicocele. Conclusions CDFI is non-invasive, accurate, repeatable and preferred for the diagnosis of nutcracker phenomenon complicated with left varicocele.