胡桃夹综合征的MSCTA与DSA对比研究  

Evaluation of Nutcracker Syndrome by Multi-slice Spiral CT Angiography and Digital Subtraction Angiography

作　　者：赵龙[1,2] 史河水[1] 韩萍[1] 梁惠民[1] 柳曦[1] 夏向文[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 [2]福建医科大学附属厦门市第一医院闽南PET中心,361003

出　　处：《临床放射学杂志》2009年第11期1509-1512,共4页Journal of Clinical Radiology

摘　　要：目的通过对比DSA检查结果,探讨多层螺旋CT血管造影(MSCTA)对胡桃夹综合征(nutcracker syn-drome,NCS)的临床应用价值。资料与方法对15例NCS患者的MSCTA后处理图像、DSA图像进行回顾性研究。观察左肾静脉(LRV)的形态、走行及空间结构。通过在MSCTA图像上测量狭窄处LRV的截面积(S1)与近肾端最宽处截面积(S2),计算LRV的狭窄程度,并与DSA结果进行比较。CT后处理技术采用多平面重组(MPR)、最大密度投影(MIP)及容积再现(VR)技术。结果MSCTA显示14例LRV狭窄程度分级与DSA完全相符,1例MSCTA诊断为III级,DSA诊断为II级。与DSA比较符合率为93.3%(14/15)。MSCTA评估LRV狭窄程度为(78.6±11.8)%,DSA评估狭窄程度为(76.4±12.8)%,两者比较差异无统计学意义(P>0.05)。结论MSCTA对NCS具有极高的诊断价值,为诊断该病提供了一种新的、无创性检查方法。Objective To assess the clinical application value of muhi-slice spiral CT angiography （MSCTA） in diagnosing nutcracker syndrome （NCS） by comparing with DSA results. Materials and Methods MSCTA and DSA data of 15 patients clinically diagnosed as NCS were retrospectively analyzed. The anatomy,course and relationship to the adjacent structure of left renal vein（LRV） and its branches were observed. The cross areas of LRV through the angle （sl） and at the largest lumen near the renal hilar （s2） were measured, and the extent of LRV stenosis was calculated. The results of MSCTA and DSA were compared. The imaging postprocessing techniques of MSCTA were MPR, CPR and VR. Results The results of stenosis grading demonstrated by MSCTA were accordant to DSA in 14 patients. 1 case was diagnosed grade Ⅲ by MSCTA while was grade II by DSA. The accordant rate was 93.3% （14/15）. The stenosis extent of MSCTA and DSA were （78.6 ±11.8） % and （76.4 ± 12.8） % respectively. No significant difference was revealed between them. Conclusion MSCTA as a new non-invasively examination method possesses rather high application value in the diagnosis of NCS.

关 键 词：胡桃夹综合征 肾静脉 体层摄影术 X线计算机 血管造影术 

分 类 号：R692[医药卫生—泌尿科学] R816.7[医药卫生—外科学]