128层CT血管成像对左肾静脉压迫综合征的显示及诊断价值

Diagnostic value and display of 128-slice computed tomography angiography for left renal vein entrapment syndrome

目的探讨128层CT对左肾静脉(LRV)压迫综合征的显示方法及诊断价值。方法回顾性研究三峡大学人民医院经128层螺旋CT血管成像(CTA)诊断的LRV压迫综合征患者30例,其中男性25例,女性5例;年龄15～55岁,平均年龄36岁;病程1个月～6年。采用多种后处理方法显示病变,并与肾静脉造影比较。结果对比影像学的诊断标准及肾静脉造影的"金标准",128层CT诊断阳性率非常高,达到100%;假阳性5例,假阳性率约为16.7%,5例假阳性均经肾静脉造影证实LRV内压与下腔静脉内压差小于0.49 kPa(5 cmH2O)。结论LRV压迫综合征牵涉的多种病理改变128层CTA均可显示清楚,诊断明确,可代替肾静脉造影。

Objective To study the display method and diagnostic value of 128-slice computed tomogaphy angiography（CTA） of renal veins for the left renal vein（LRV） entrapment syndrome. Methods A total of 30 patients with LRV entrapment syndrome were enrolled, male 25, female 5, aged 15 - 55 years old, mean age 36 years old, course of 1-month to 6-year. The postprocessing method was used variety of display, and compared with renal vein angiography. Results The radiological diagnostic criteria and renal venography of the ＂gold standard＂ was compared,the 128-slice CTA positive rate of diagnosis was very high, reached 100 %; false positive in 5 cases, false-positive rate about 16.7 %. False positive in 5 cases were confirmed by renal venography of LRV, and the inferior vena cava pressure within the pressure was less than 0.49 kPa（5 cmH20）. Conclusion It is demonstrated that the LRV entrapment syndrome involves a variety of pathological changes in 128-slice CTA could be display clearly, and instead of renal venography.