中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
9期
31-33
,共3页
胡桃夹综合征%左肾静脉%血尿%螺旋CT
鬍桃夾綜閤徵%左腎靜脈%血尿%螺鏇CT
호도협종합정%좌신정맥%혈뇨%라선CT
Nutcracker syndrome%Left renal vein%Hematuria%Spiral CT
目的 探讨多层螺旋CT(MSCT)在诊断胡桃夹综合征(NCS)中的应用价值及临床意义.方法 回顾性分析33例经临床和相关检查确诊为NCS患者的MSCT增强扫描及血管成像的影像学资料,应用最大密度投影(MIP)、多平面重建(MPR)、曲面重建(CPR)及容积重建(VR)后处理重建技术,测量左肾静脉(LRV)中心平面肠系膜上动脉(SMA)与腹主动脉(AA)的间距、SMA与AA的夹角、LRV扩张段(a)和狭窄段(b)的内径及截面积大小,并计算a/b值和s2/s1值.结果 SMA、AA、LRV均显示清晰直观,LRV中心平面SMA与AA间距为(3.60±0.66)mm,SMA与AA夹角为(28.33±8.32)°,夹角内LRV外压性变扁狭窄,呈“漏斗”状,LRV肾门最粗处血管内径与狭窄段血管内径(a/b)比值为(4.9±1.5),截面积(s2/s1)比值为(3.6±1.6),与正常状态下差别较大.LRV狭窄段外侧肾静脉及属支增粗扩张33例,左肾实质强化程度低于右肾20 Hu以上2例.结论 MSCT血管成像立体直观,可从不同角度观察显示AA、SMA、LRV、IVC的解剖关系、病理形态及伴随征象,并可精确测量多种相关数值,判断评估LRV狭窄程度,结合其他影像学检查,为诊治NCS提供有力的证据.
目的 探討多層螺鏇CT(MSCT)在診斷鬍桃夾綜閤徵(NCS)中的應用價值及臨床意義.方法 迴顧性分析33例經臨床和相關檢查確診為NCS患者的MSCT增彊掃描及血管成像的影像學資料,應用最大密度投影(MIP)、多平麵重建(MPR)、麯麵重建(CPR)及容積重建(VR)後處理重建技術,測量左腎靜脈(LRV)中心平麵腸繫膜上動脈(SMA)與腹主動脈(AA)的間距、SMA與AA的夾角、LRV擴張段(a)和狹窄段(b)的內徑及截麵積大小,併計算a/b值和s2/s1值.結果 SMA、AA、LRV均顯示清晰直觀,LRV中心平麵SMA與AA間距為(3.60±0.66)mm,SMA與AA夾角為(28.33±8.32)°,夾角內LRV外壓性變扁狹窄,呈“漏鬥”狀,LRV腎門最粗處血管內徑與狹窄段血管內徑(a/b)比值為(4.9±1.5),截麵積(s2/s1)比值為(3.6±1.6),與正常狀態下差彆較大.LRV狹窄段外側腎靜脈及屬支增粗擴張33例,左腎實質彊化程度低于右腎20 Hu以上2例.結論 MSCT血管成像立體直觀,可從不同角度觀察顯示AA、SMA、LRV、IVC的解剖關繫、病理形態及伴隨徵象,併可精確測量多種相關數值,判斷評估LRV狹窄程度,結閤其他影像學檢查,為診治NCS提供有力的證據.
목적 탐토다층라선CT(MSCT)재진단호도협종합정(NCS)중적응용개치급림상의의.방법 회고성분석33례경림상화상관검사학진위NCS환자적MSCT증강소묘급혈관성상적영상학자료,응용최대밀도투영(MIP)、다평면중건(MPR)、곡면중건(CPR)급용적중건(VR)후처리중건기술,측량좌신정맥(LRV)중심평면장계막상동맥(SMA)여복주동맥(AA)적간거、SMA여AA적협각、LRV확장단(a)화협착단(b)적내경급절면적대소,병계산a/b치화s2/s1치.결과 SMA、AA、LRV균현시청석직관,LRV중심평면SMA여AA간거위(3.60±0.66)mm,SMA여AA협각위(28.33±8.32)°,협각내LRV외압성변편협착,정“루두”상,LRV신문최조처혈관내경여협착단혈관내경(a/b)비치위(4.9±1.5),절면적(s2/s1)비치위(3.6±1.6),여정상상태하차별교대.LRV협착단외측신정맥급속지증조확장33례,좌신실질강화정도저우우신20 Hu이상2례.결론 MSCT혈관성상입체직관,가종불동각도관찰현시AA、SMA、LRV、IVC적해부관계、병리형태급반수정상,병가정학측량다충상관수치,판단평고LRV협착정도,결합기타영상학검사,위진치NCS제공유력적증거.
Objective To investigate the value and clinical significance of multi-slice CT (MSCT) in the diagnosis of nutcracker syndrome(NCS).Methods The enhanced MSCT angiography scanning and image data of 33 cases of NCS were retrospectively analyzed.With the application of MPR,CPR,MIP and VR reconstruction of post-processing techniques,the distance between SMA and AA in the left renal vein (LRV) central plane,the angle of SMA and AA,the inner diameter and cross-sectional area of LRV expansion section(a) and narrow section(b) were measured,and a/b ratio and s2/s1 values were calculated.Results SMA,AA,LRV showed clear and intuitive,the distance between SMA and the AA in the LRV central plane was(3.60 ±0.66)mm,the angle of SMA and AA was(28.33 ± 8.32)°.Between the angle,the LRV was pressed to be "funnel" shaped,the ratio of the inner diameter of the thickest LRV in renal hilum and the diameter of the stenotic part of blood vessel (a/b) was (4.9 ± 1.5),the ration of cross-sectional area(s2/sl) was(3.6 ± 1.6),which was significantly different from normal values.The renal vein which was distal to the stenotic part of LRV and the accessory veins dilated in 33 cases.Parenchymal enhancement in the left kidney was 20 Hu lower than the right one in two cases.Conclusions MSCT angiography is dimensional and intuitive,in which the anatomical relations of AA,SMA,LRV,IVC,the pathological changes,the accompanied pathological signs can be shown from different angles,many parameters can be accurately measured,and the stenotic degree of LRV can be assessed.Together with other imaging tests,it can provide strong evidence for the diagnosis and treatment of NCS.
