彩超及CTA对胡桃夹综合征的诊断价值  

Diagnostic value of color Doppler ultrasound and computed tomography angiography for nut-cracker syndrome

作　　者：崔林刚[1] 孟庆军[1] 徐全全[1] 朱海彬[1] 赵高贤[1] 赵永立[1] 高瞻[1] 李战宾 文建国[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《现代泌尿外科杂志》2012年第4期371-373,386,共4页Journal of Modern Urology

摘　　要：目的探讨彩超及CTA对胡桃夹综合征(NCS)的诊断价值。方法分析50例NCS患者及50例健康人的资料。结果主诉肉眼及镜下血尿31例;疲乏伴纳差4例;左精索静脉曲张10例;蛋白尿伴左腰不适5例。13例女性有盆底淤血征,男性均有不同程度左精索静脉曲张。彩超肠系膜上动脉(SMA)和腹主动脉(AO)夹角(a)(25.08±11.83)°vs.(48.73±25.82)°;左肾静脉(LRV)受压管径(D1)(2.45±1.28)vs.(3.48±1.02)cm,血流速度(V1)(0.38±0.16)vs.(0.48±0.13)m/s;LRV远端管径(D2)(8.55±2.63)vs.(7.43±2.03)cm,血流速度(V2)(0.28±0.21)vs.(0.94±0.43)m/s。21例CTA示SMA与AO夹角减小,1例示胰头部压迫,3例SMA分支及下方纤维结构压迫;1例后胡桃夹征(腹主动脉和脊柱之间压迫),15例膀胱镜左输尿管口喷血。结论彩超初步筛选胡桃夹征,CTA更清晰显示LRV周围结构。Objective To evaluate the value of color Doppler ultrasound and computed tomography angiography（CTA） in the diagnosis of nut-cracker syndrome.Methods Data of 50 cases of nut-cracker syndrome and 50 healthy controls were analyzed.Results 31 patients had hematuria,4 had fatigue and poor appetite,10 had left varicocele,and 5 had proteinuria and waist pains.13 women patients had pelvic congestion syndrome（PCS）.All male patients had left varicocele in varying degrees.Doppler ultrasound showed the angel between superior mesenteric artery（SMA） and aorta was（25.08±11.83）°vs.（48.73±25.82） °.The left renal vein（LRV） diameters of the angle segment were（8.55±2.63） vs.（7.43±2.03） cm,and the flow velocity was（0.38±0.16） vs.（0.48±0.13） m/s.The LRV diameters of the portal segment were（8.55±2.63） vs.（7.43±2.03） cm and the flow velocity was（0.28±0.21） vs.（0.94±0.43） m/s.CTA showed that 21 patients had decrescent angle between SMA and aorta,1 patient had oppressed LRV in the head of pancreas,3 patients had oppressed LRV in the branches of SMA and inferior fibrous structure,and 1 patient had oppressed LRV in the abdominal aorta and the vertebral column.Cystoscopy revealed spouting blood in the left ureteral orifice.Conclusions The color Doppler examination can screen nut-cracker syndrome and CTA can accurately measure the spatial structure around LRV.

关 键 词：胡桃夹综合征 彩超 CT血管成像 诊断 

分 类 号：R695.1[医药卫生—泌尿科学]