多排螺旋CT对胡桃夹综合征和胡桃夹现象的诊断价值  

The value of multi-detector CT in diagnosis of nutcracker syndrome and nutcracker phenomenon

作　　者：马爱冬[1] 吴涛[2] MA Aidong;WU Tao(CT Room of Jining First People's Hospital,Jining 272011,China;Second Medical College,Jining Medical University,Jining 272067,China)

机构地区：[1]济宁市第一人民医院CT室,济宁272011 [2]济宁医学院第二临床医学院,济宁272067

出　　处：《济宁医学院学报》2024年第4期319-321,共3页Journal of Jining Medical University

基　　金：济宁市重点研发项目(2023YXNS186);济宁医学院博士启动基金项目(JNBQ202301)。

摘　　要：目的探讨多排螺旋CT(MDCT)对胡桃夹综合征(NCS)和胡桃夹现象(NCP)的诊断价值。方法纳入2018年1月至2024年6月本院患者22例,其中NCS患者13例,NCP患者9例。评价CT平扫图像肠系膜上动脉(SMA)、左肾静脉(LRV)的可见性。在CT增强重建图像上测量主动脉SMA夹角(AMA)、LRV近段最宽处前后径(D1)、经AMA处前后径(D2)并计算D1/D2比值。结果成人SMA、LRV在MDCT平扫图像上可见性较好。NCS组AMA、D1、D2、D1/D2分别为15.14°±3.54°,(11.00±2.38)mm,(2.76±0.43)mm,4.08±1.19;NCP组分别为22.42°±4.97°,(10.55±1.66)mm,(4.00±0.70)mm,2.70±0.53。两组AMA、D2、D1/D2存在显著性差异(P<0.05)。结论MDCT平扫可以提示或排除NCP、NCS的诊断。MDCT增强成像可以全面评估腹部血管形态和LRV侧支循环,结合临床可确诊NCS。Objective To investigate the value of Multidetector CT(MDCT)scan in the diagnosis of Nutcracker syndrome(NCS)and Nutcracker phenomenon(NCP).Methods Twenty-two patients were included in this retrospective study from January 2018 to June 2024.including 13 NCS patients and 9 NCP patients.The clinical manifestations and the CT features in different groups were analyzed.The visibility of SMA and LRV on unenhanced CT was evaluated.On the enhanced CT reconstraction images,the aortomesenteric angle(AMA),the anteroposterior diameter of the widest point of the proximal left ranal vein(D_(1)),the anteroposterior diameter at the AMA(D_(2)),and the D_(1)/D_(2) ratio were measured.Results SMA and LRV of adults are visible on unenhanced CT scan.The AMA,D1,D2,D1/D2 in NCS group(13 cases)were 15.14°±3.54°,11.00±2.38mm,2.76±0.43mm,4.08±1.19,and the NCP group were 22.42°±4.97°,10.55±1.66mm,4.00±0.70mm,2.70±0.53,respectively.There was a significant difference(P<0.05)of AMA,D2,D1/D2 values between NCS group and NCP group.Conclusion Unenhanced MDCT is capable of suggesting or excluding the diagnosis of NCS or NCP,while enhanced MDCT can provide a comprehensive assessment of abdominal vascular morphology and the collateral circulation of the LRV,allowing for a difinitive diagnosis of NCS when combined with clinical information.

关 键 词：左肾静脉压迫综合征 胡桃夹现象 胡桃夹综合征 多排螺旋CT 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.6[医药卫生—放射医学]