摘要
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（s21s1）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20Hu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。
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 were retrospectively analyzed. With NCS 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/sl values were calculated. Re- suits 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 an- gle, 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 re- nal vein which was distal to the stenotic part of LRV and the accessory veins dilated in 33 cases. Parenchy- mal 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 pa- rameters can be accurately measured, and the stenotic degree of LRV can be assessed. Together with oth- er imaging tests, it can provide strong evidence for the diagnosis and treatment of NCS.
出处
《中国实用医刊》
2014年第9期31-33,共3页
Chinese Journal of Practical Medicine
