Abstract:Objective To explore the value of multi-slice spiral CT(MSCT) and ultrasonography (US) in diagnosing nutcracker phenomenon (NCP). Methods The imaging data on 60 patients with abdominal MSCT and US was retrospectively analyzed. The 30 patients in the observation group were confirmed as cases of NCP.In the control group, 30 patients without NCP who underwent abdominal MSCT and US examination for other reasons were randomly selected.The aortomesenteric angle (AMA), the inner diameter (DD) and peak velocity (PVd) of the left renal vein near hilar dilatation, the inner diameter (DN) and peak velocity (PVn)of the narrowest part of the LRV in the AMA were obtained and analyzed statistically. Results Both MSCT and US could accurately measure AMA,DD and DN. An independent examination showed statistically significant difference in the data on the two groups(P<0.05), while the single-factor comparison between the two examination methods showed no significant difference (P>0.05). PVd and PVn could be measured in US, and there was significant difference between the two groups (P<0.05).However, MSCT had obvious advantages in the diagnosis of concomitant symptoms in patients with NCP.In the observation group using MSCT examination, there were 12 cases of dilatation and thickening of the left lumbar vein and reproductive vein, 7 cases of narrowing of horizontal parts of duodenum, 5 cases of enlargement of the left kidney volume compared to the right kidney, and 3 cases of decrease in CT enhancement density of the left renal cortex compared with the contralateral renal cortex. Conclusions MSCT and US are the main means of diagnosis of NCP, but MSCT is superior.
焦健, 都基权, 孟玫, 张鹏. 多层螺旋CT与超声诊断胡桃夹现象的价值[J]. 武警医学, 2021, 32(10): 885-888.
JIAO Jian, DU Jiquan, MENG Mei, ZHANG Peng. The role of multi-slice spiral CT and ultrasonography in the diagnosis of nutcracker phenomenon. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(10): 885-888.
Yun S J, Lee J M, Nam D H,et al. Discriminating renal nutcracker syndrome from asymptomatic nutcracker phenomenon using multidetector computed tomography[J].Abdom Radiol (NY),2016,41(8):1580-1588.
[5]
Yun S J, Nam D H, Ryu J K, et al. The roles of the liver and pancreas in renal nutcracker syndrome[J]. Eur J Radiol,2014,83(10):1765-1770.
[6]
Dunphy L, Penna M, Tam E, et al. Left renal vein entrapment syndrome: nutcracker syndrome![J],BMJ Case Rep,2019,12(9):e230877.
Zerin J M, Hernandez R J, Sedman A B, et al. “Dilatation” of the left renal vein on computed tomography in children: a normal variant[J].Pediatr Radiol,1991,21(4):267-269.
[9]
Yin H, Zhao J, Du L.Incidental finding of the nutcracker phenomenon detected by 18F-FDG PET/CT[J]. Clin Nucl Med,2013,38(3):212-214.
[10]
Inal M, Karadeniz M Y, Sahin S. Nutcracker syndrome accompanying pelvic congestion syndrome; color doppler sonography and multislice CT findings: a case report[J]. Iran J Radiol,2014,11(2):e11075.
[11]
Oh M J. Superior mesenteric artery syndrome combined with renal nutcracker syndrome in a young male: a case report[J]. Korean J Gastroenterol,2017,70(5):253-260.
[12]
Özkan M B, Ceyhan B M, Hayalioglu E. Anterior and posterior nutcracker syndrome accompanying left circumaortic renal vein in an adolescent: case report[J]. Arch Argent Pediatr,2016,114(2):e114-e116.
[13]
Moreno M C, Galván M D, Cortés Sañudo X,et al. An unusual association: median arcuate ligament syndrome and nutcracker syndrome[J]. Rev Esp Enferm Dig,2019,111(3):241-242.