多层螺旋CT诊断胡桃夹综合征的价值  

Evaluation of the nutcracker syndrome using multi-slice spiral CT

作　　者：史河水[1] 樊艳青[1] 韩萍[1] 周承凯[1] 赵龙[1] 吴红英[1] 于群[1] 刘永华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《中华放射学杂志》2007年第10期1082-1084,共3页Chinese Journal of Radiology

摘　　要：目的探讨多层螺旋 CT(MSCT)对胡桃夹综合征(NCS)的诊断价值。方法回顾性分析16例经临床和相关检查诊断为 NCS 的患者(病变组)与80例正常肾血管者(对照组)的 MSCT血管影像或 CT 增强扫描的影像资料。观察左肾静脉(LRV)及其属支的形态、走行位置以及与邻近结构的关系,测量2组中肠系膜上动脉(SMA)与腹主动脉(AA)的夹角(a)、SMA 与 AA 三角间隙内LRV 断面中点水平 SMA 后缘与 AA 前缘的距离(d),在 LRV 横断面上分别测量:SMA 和 AA 间隙内LRV 的截面积(s1)、近肾侧 LRV 管径最大点截面积(s2),并计算 s2和 s1的比值(q),进行统计学分析。结果病变组 LRV 均明显扩张,其中7例合并性腺静脉增粗。LRV 狭窄并回流受阻的原因为:14例 SMA 与 AA 的夹角狭小,2例 LRV 走行于 AA 后。病变组的 a、d、s1、s2和q(s2/s1)分别为:(21±4)°、(0.53±0.11)cm、(0.28±0.06)cm^2、(1.42±0.48)cm^2、5.26,对照组上述指标分别为(52±24)°、(1.39±0.70)cm、(0.81±0.32)cm^2、(1.21±0.35)cm^2及1.52,差异均有统计学意义(P<0.05)。结论利用 MSCT 能精确测量并判断 LRV 狭窄的程度,为诊断和治疗 NCS 提供了一种新的无创性检查方法。Objective To evaluate the ability of multi-slice spiral CT （MSCT） in diagnosing nutcracker syndrome（ NCS）. Methods MSCT angiography （ MSCTA ） or contrast enhanced CT data of 16 patients clinically diagnosed as NCS（ patient group） and 80 subjects with nomal kidneys and renal vessels （control group） were retrospectively reviewed. The anatomy, course and relationship to the adjacent structure of left renal vein （LRV） and its branches were observed. The angle （a） between SMA and the abdominal aorta（AA）, the distance（d） between SMA and AA at the level of LRV passing through, the cross areas of LRV through the angle （ s1 ） and at the largest diameter near the renal hilar （ s2 ） were measured and the ratio（q） of s2 to sl was calculated. Results All LRVs were compressed and showed dilated, 7 of them with the genesial gland vein enlargement. The causes of the LRV narrowing and obstruction were small angle （a） in 14 patients and abnormal path of LRV posterior to AA in 2 cases. The value of a,d,s1 ,s2 and q in the patient group and the control group were ： （ 21±4）°, （ 0.53±0. 11 ） cm, （0. 28±0. 06） cm^2, （ 1.42 ± 0.48 ） cm^2, 5.26 and （ 52 ± 24 ）°, （ 1.39 ± 0. 70） cm, （ 0. 81 ± 0. 32） cm^2, （ 1.21 ± 0. 35 ） cm^2, 1.52, respectively. The differences were significant between the two groups （ P 〈 0. 05 ）. Conclusion The appearance and its path of the LRV could be well delineated on the MSCT, allowing a accurate evaluation of the LRV narrowing non-invasively.

关 键 词：体层摄影术 X线计算机 肾静脉 血管造影术 

分 类 号：R816.7[医药卫生—放射医学]