彩色多普勒超声对45例胡桃夹现象的诊断及支架植入术后的监测  

Diagnostic significance of nutcracker phenomenon and evaluation on intravenous stent placement for treatment with color doppler flow imaging

作　　者：王俊芳[1] 徐宏贵[1] 罗良平[1] 

机构地区：[1]暨南大学附属第一医院超声科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2008年第6期602-605,608,共5页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的:探讨彩色多普勒超声对胡桃夹现象患者的诊断意义、左肾静脉受压程度与临床表现之间的关系及对胡桃夹现象患者支架植入术后疗效的评价意义。方法:回顾分析45例胡桃夹现象患者的彩色多普勒超声表现,并将其与数字减影血管造影检查对照;按照临床表现将其分为3组:精索静脉曲张组、血尿组、蛋白尿组,分别测量左肾静脉受压狭窄部位(b)及受压扩张部位近端内径(a),扩张部位左肾静脉血流速度(Va)及受压部位血流速度(Vb),分析比较各组左肾静脉的受压程度;对其中行左肾静脉支架植入术的7例胡桃夹现象患者术后进行超声检查,测量上述指标并与其术前检查结果对比。结果:45例患者均见左肾静脉受压征象,受压部位前可见扩张,仰卧位时扩张部位内径(a)/受压部位内径(b)>3.0,受压部位血流速度(Vb)大于扩张部位血流速度(Va);各组间a/b值与Vb/Va值差异不具有统计学意义(P>0.05);行左肾静脉支架植入术治疗的7例胡桃夹现象患者术前与术后的b值、Vb值相比差异均有显著性(P<0.05)。结论:彩色多普勒超声诊断胡桃夹现象既方便又实用,可为精索静脉曲张、反复血尿、蛋白尿而无法用实验室检查确诊的患者提供有意义的临床指导,而且可作为胡桃夹现象患者支架植入术后疗效评估的一种手段。Aim：To investigate the diagnostic significance and the relationship between left renal vein entrapment syndrome and their symptoms on nutcracker phenomenon（NCP） and assess the value of intravenous stent placement for treatment of nutcracker by color doppler flow imaging（CDFI）. Methods： Ultrasonograms of 45 patients with nutcracker phenomenon were analyzed and some of them were compared with the results of digital subtraction angiography examination（DSA）. According to their clinical manifestations,45 cases were divided into three groups： varicocele,hematuria and proteinuria. The left renal vein was measured respectively by ultrasound, the parameters included interior diameter between superior mesenteric artery （SMA） and abdominal aorta （AbAO） （b）, proximal interior diameter of left renal vein（a） and their corresponding blood flow velocity（Vb,Va）. Those parameters of 7 cases who were treated with intravenous stent placement were measured preoperatively and postoperatively by ultrasound. Results： In the 45cases, the left renal vein was compressed between the AbAO and the SMA,and the left renal vein before the compressed site was dilated. The rations of a and b are more than 3.0, Vb is much quicker than Va. There were no differences on the rations of a and b, Vb and V, （P 〉 0.05）. There was a big difference on the b and Vb of the before operation and after operation in the patients who were treated with intravenous stent placement（P 〈0.05）. Conclusion： Colordoppler is convenient and practical for the diagnosis of NCP with CDFI. It provides us with a clinical meaningful direction to the diagnosis of the varieoeele, the reversal hematuria and proteinuria that can＇t be assured by laboratory examinations. Furthermore, it can be used to assess the value of intravenous stent placement for treatment of nutcracker phenomenon.

关 键 词：胡桃夹 左肾静脉 彩色多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]