多层螺旋CT三维重建在左肾静脉压迫综合征中的临床应用  

The Application of Multi-slice Spiral CT Three Dimensional Reconstruction in Left Renal Vein Entrapment Syndrome

作　　者：龚洪翰[1] 王进华[1] 姜建[1] 何来昌[1] 孟栋良[2] 陈旺强[1] 王敏[1] 王敏君[1] 纪玉强[1] 邱春梅[1] 肖香佐[1] 

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006 [2]江西省人民医院泌尿科

出　　处：《实用放射学杂志》2007年第5期620-623,共4页Journal of Practical Radiology

摘　　要：目的探讨多层螺旋CT（MSCT）三维重建在左肾静脉压迫综合征中的诊断价值。方法应用16层螺旋CT对11例左肾静脉压迫综合征病例进行泌尿系增强多期扫描,并获得各种后处理图像。结果11例左肾静脉压迫综合征病例均可见肠系膜上动脉（SMA）压迫左肾静脉（LRV）的征象。CT多平面重建（MPR）直观地显示了腹主动脉（AO）与SMA之间的夹角（α）,最大为21.88,°最小为12.86°,平均为17.95°。CT横断位图像显示扩张的左肾静脉直径为12-15.3 mm,平均为13.26 mm;LRV受SMA压迫狭窄处直径为3.0-4.0mm,平均为3.26 mm。左侧卵巢静脉或睾丸静脉直径为2.1-2.6mm,平均为2.2mm。5例增强扫描肾实质期（后期）显示双肾实质密度相差20 HU以上。结论MSCT在胡桃夹综合征诊断中具有明显的优势。Objective To explore the value of three dimensional reconstruction of multi - slice spiral CT in the diagnosis of left renal vein entrapment syndrome. Methods Multi - phase scans of urological system were performed in 11 cases with 16 - slice CT scanner,the images of all cases were reconstructed three - dimensionally and acquired all kinds of post - processing images. Results The sign of superior mensenteric artery（ SMA） entrapping left renal vein （ LRV ） was showed in all cases, the angle between abodominal aorta （AO） and SMA could be showed directly by multiplanar reformation, the maximal, minimal and mean angle were 21.88° , 12.86°and 17.95 °respectively. On CT transversal images, the range of the diameter and mean value of expansion of LRV were 12 - 15.3 mm and 13.26 mm respectively, the diameters of left ovarian vein or testicular vein were 2.1 - 2.6 mm （ mean 2.2 mm）. The range of the diameter of stenosis of LRV at compressed with SMA was 3.0 - 4.0 mm, with mean value 3.26 mm. Contrast -enhanced CT were performed in 11 cases, the CT value between two kidneys of 5 cases were different over 20 HU on delyed parcnehymal phase. Conclusion Multi - slice spiral CT have an obvious advan- tage in diagnosis of left renal vein entrapment syndrome.

关 键 词：肾 体层摄影术 X线计算机 胡桃夹现象 肠系膜上动脉 左肾静脉压迫综合征 

分 类 号：R692[医药卫生—泌尿科学] R814.42[医药卫生—外科学]