中国中西医结合影像学杂志
中國中西醫結閤影像學雜誌
중국중서의결합영상학잡지
Chinese Imaging Journal of Integrated Traditional and Western Medicine
2015年
5期
518-520,538
,共4页
超声检查,多普勒,彩色%肾静脉%肾淤血%胡桃夹综合征
超聲檢查,多普勒,綵色%腎靜脈%腎淤血%鬍桃夾綜閤徵
초성검사,다보륵,채색%신정맥%신어혈%호도협종합정
Ultrasonography%Doppler%color%Renal vein%Renal hematocele%Nutcracker Syndrome
目的:探讨胡桃夹综合征(nutcracker syndrome,NCS)合并肾脏器质性病变的超声诊断价值,提高对NCS及合并症的诊断水平. 方法:收集16例NCS,应用二维超声、CDFI、频谱多普勒、能量多普勒血流显像探查腹主动脉、肠系膜上动脉与左肾静脉的位置关系. 平卧位及脊柱后伸位分别测量肠系膜上动脉和腹主动脉夹角、左肾静脉受压段管腔前后径(a)和血流速度Va;扩张段管腔前后径(b)和血流速度Vb. 以DSA检查结果作为对照,分析超声诊断NCS的灵敏度和漏诊率. 结果:超声诊断NCS的灵敏度为87.50%,漏诊率为12.50%. 16例NCS中单纯NCS 3例(18.75%);合并肾脏器质性病变13例(81.25%),其中,IgA肾病6 例(37.50%),慢性肾小球肾炎3 例(18.75%),微小病变肾病 2 例(12.50%),膜性肾病 1 例(6.25%),胡桃夹现象(nut cracker phenomenom,NCP)1例(6.25%). 结论:超声是诊断NCS的首选影像学检查方法. 临床医师应密切关注NCS患者24 h蛋白尿指标,及时行肾穿刺活检,准确诊断NCS合并肾脏器质性病变.
目的:探討鬍桃夾綜閤徵(nutcracker syndrome,NCS)閤併腎髒器質性病變的超聲診斷價值,提高對NCS及閤併癥的診斷水平. 方法:收集16例NCS,應用二維超聲、CDFI、頻譜多普勒、能量多普勒血流顯像探查腹主動脈、腸繫膜上動脈與左腎靜脈的位置關繫. 平臥位及脊柱後伸位分彆測量腸繫膜上動脈和腹主動脈夾角、左腎靜脈受壓段管腔前後徑(a)和血流速度Va;擴張段管腔前後徑(b)和血流速度Vb. 以DSA檢查結果作為對照,分析超聲診斷NCS的靈敏度和漏診率. 結果:超聲診斷NCS的靈敏度為87.50%,漏診率為12.50%. 16例NCS中單純NCS 3例(18.75%);閤併腎髒器質性病變13例(81.25%),其中,IgA腎病6 例(37.50%),慢性腎小毬腎炎3 例(18.75%),微小病變腎病 2 例(12.50%),膜性腎病 1 例(6.25%),鬍桃夾現象(nut cracker phenomenom,NCP)1例(6.25%). 結論:超聲是診斷NCS的首選影像學檢查方法. 臨床醫師應密切關註NCS患者24 h蛋白尿指標,及時行腎穿刺活檢,準確診斷NCS閤併腎髒器質性病變.
목적:탐토호도협종합정(nutcracker syndrome,NCS)합병신장기질성병변적초성진단개치,제고대NCS급합병증적진단수평. 방법:수집16례NCS,응용이유초성、CDFI、빈보다보륵、능량다보륵혈류현상탐사복주동맥、장계막상동맥여좌신정맥적위치관계. 평와위급척주후신위분별측량장계막상동맥화복주동맥협각、좌신정맥수압단관강전후경(a)화혈류속도Va;확장단관강전후경(b)화혈류속도Vb. 이DSA검사결과작위대조,분석초성진단NCS적령민도화루진솔. 결과:초성진단NCS적령민도위87.50%,루진솔위12.50%. 16례NCS중단순NCS 3례(18.75%);합병신장기질성병변13례(81.25%),기중,IgA신병6 례(37.50%),만성신소구신염3 례(18.75%),미소병변신병 2 례(12.50%),막성신병 1 례(6.25%),호도협현상(nut cracker phenomenom,NCP)1례(6.25%). 결론:초성시진단NCS적수선영상학검사방법. 림상의사응밀절관주NCS환자24 h단백뇨지표,급시행신천자활검,준학진단NCS합병신장기질성병변.
Objective:To evaluate the diagnostic value of color Doppler ultrasound in nutcracker syndrome,to analyze the CDFI of the combining renal organic disease,and improve the diagnostic level of NCS and the complication. Methods:By Two-di-mensional,color Doppler flow imaging,pulsed wave Doppler,power Doppler ultrasonography,to ascertain position relation of ab-dominal aorta , superior mesenteric artery and left renal vein , then inner-diameter of the narrow ( a ) and blood flow velocity (Va),dilated (b) and blood flow velocity (Vb) portion of the compressed left renal vein was measured. To repeat measuring a, Va and b,Vb after extending back on standing position. As a gold standard with result of DSA,sensitivity and false negative rate of nutcracker syndrome were calculated by transabdominal ultrasound. The incidence rate of combining renal organic dis-ease and △P was calculated too. very well laboratory examination and renal puncture biopsy and DSA. Results:the diagnostic value of color Doppler ultrasound in NCS:Sensitivity was 87.5%,false negative rate was 12.5%. Among nutcracker syndrome cases,simple nutcracker syndrome accounted for 18.8% (3/16);combined IgA nephropathy accounted for 37.5% (6/16);combined chronic glomerulonephritis accounted for 18.8% (3/16);combined minimal change nephropathy accounted for 12.5% (2/16);combined membranous nephropathy accounted for 6.3% (1/16);nut cracker phenomenom accounted for 6.3% (1/16). combined renal organic disease accounted for 81 . 2% ( 13/16 ) . Conclusion:Transabdominal ultrasound can be used as the preferred method for clinical diagnosis of nutcracker syndrome. Clinician should show solicitude for urine protein quantity in 24 hour of patient with nutcracker syndrome,perform renal puncture biopsy on time,and diagnose nutcracker syndrome accurately with combining renal organic disease.
