多层螺旋CT(MSCT)在诊断胡桃夹综合征中的临床应用

Clinical Application of Multi-slice Spiral CT(MSCT) in the Diagnosis of Nutcracker Syndrome

目的探讨多层螺旋CT(MSCT)在诊断胡桃夹综合征(NCS)中的临床应用价值。方法收集2012年3月至2016年8月期间我院收治的13例NCS患者的病历资料及MSCT影像学资料,另选同期我院体检的健康志愿者10名作为对照分析,分别为NCS组(n=13)和对照组(n=10),比较两组MSCT影像学资料分析结果,并总结NCS患者的MSCT表现。结果与对照组相比,NCS组SMA与AA夹角、近肾端最宽处与夹角处截面积比值、左右肾体积差均明显较大,LRV夹角最宽处内径均显著较小(P<0.05)。MSCT表现:13例患者SMA自AA呈锐角分出,两者之间交角明显变小;LRV走行于腹主动脉与脊柱之间,近肾端在夹角处明显受压变窄或变细,呈"鹰嘴状""哑铃状"狭窄,近肾门段呈明显扩张。结论 NCS患者的MSCT图像清晰,可较好地显示患者LRV走向、形态及SMA与AA夹角,可与正常者进行较好的区分诊断,对NCS的临床诊疗有重要价值。

Objective To evaluate the clinical application value of multi-slice spiral CT （MSCT） in the diagnosis of nutcracker syndrome （NCS）. Methods The clinical data and MSCT imaging dataof 13 patients with NCS admitted to our hospital between January 2014 and Augnst 2016 were collected, and 10 healthy volunteers in our hospital were selected for contrast analysis. They were respectively included in NCS （n= 13） and control group 01=10）. The analysis results of MSCT imaging data were compared between the two groups, and the MSCT findings of NCS were summarized. Results Compared with the control group, the included angleof SMA and AA, the ratio of the widest part of kidney and the sectional areaof included angle, and the difference between the left and right kidney in NCS group were significantly larger than those in the control group, while the inner diameter of the widest part of LRV included angle was significantly smaller （P〈 0.05）.MSCT findings showed that SMA of 13 cases separated from AA in acute angle, and the crossing angle between the two decreased;LRV located between the abdonfinal aorta and the spine. The proximal end of the kidney was significantly narrowed or thin under press, with olecranon-like and dumbbell shaped stenosis, and the segment near renal portal was significantly expanded. Conclusion MSCT images of patients with NCS are clear, which can better display the patient＇s LFZV direction, shape and included angle of SMA and AA. The images can be distinguishedfrom those of normal people, which is of important value in the clinical diagnosis and treatment of NCS.