彩色多普勒超声对胡桃夹综合征的诊断研究

Color Doppler Ultrasound in The Diagnosis of Nutcracker Syndrome

目的:应用彩色多普勒超声研究疑似胡桃夹综合征左肾静脉各项参数指标。方法:通过对15例疑似胡桃夹结构患者进行彩色多普勒超声检查,观察肠系肠上动脉(SMA)与腹主动脉(AO)之间的夹角(β),测量左肾静脉(LRV)受压狭窄部位内径(Db)及受压扩张部位内径(Da),脉冲多普勒测量受压部位血流速度(Vb)及扩张部位血流速度(Va),站立背伸位15min后重复测量上述指标。计算两种体位下Da/Db、Vb/Va及最窄处压力阶差(△P)。结果:15例患者SMA与AO之间夹角均<30度。不同体位,15例患者的LRV的Da均较Db明显增宽,Vb均较Va明显增快,△P均升高;平卧位时,Da/Db>2,Vb/Va>3.7,△P>3;站立背伸位15min后,Da/Db>3.0,Vb/Va>5.5,△P>5.5。结论:彩色多普勒超声可动态观察胡桃夹结构左肾静脉内径及其血流动力学变化,并可准确测量获取各项参数指标,对胡桃夹综合征的诊断及指导转归有重要意义。

Objective： To study the parameters of left renal vein of suspected nutcrack syndrome by color Doppler ul- trasonography. Methods： The angle between the superior intestinal artery （SMA） and the abdominal aorta （AO） was meas- ured by color Doppler ultrasonography in 15 patients with suspected nutcracker. The left renal vein （ LRV （Db） and the diam- eter of the compression site （ Da）, the pulse velocity （Vb） and the velocity of the dilated blood flow （Va） were measured by pulsed Doppler imaging, and the standing dorsiflexion was repeated for 15 rain Measure the above indicators. Calculate the Da / Db, Vb ! Va and the narrowest pressure difference （ A P） at the two positions. Results： The angle between SMA and AO was 〈30 degrees in 15 patients. （P 〈0.05） . Therefore, Da/Db〉 2, Vb/Va〉 3.7, A P （P 〈0.05） were signifi- candy higher than those in Db （P 〈 0. 05） 〉 3 ; standing back extension 15min, Da / Db 〉 3.0, Vb / Va 〉 5. 5, a P 〉 5.5. Conclusion： Color Doppler ultrasonography can dynamically observe the changes of left renal vein diameter and hemody- namics of nutcracker, and can accurately measure and obtain the parameters, which is of great significance to the diagnosis and guiding outcome of nutcracker syndrome.