彩色多普勒超声对胡桃夹综合征的诊断价值

[目的]探讨彩色多普勒超声在诊断胡桃夹综合征（nutcrackersyndrome，NCS）中的临床应用价值。[方法]应用彩色多普勒超声多体位检测NCS患者组（49例）和健康对照组（50例），分别测量其左肾静脉近肾端扩张处内径a和经过腹主动脉和肠系膜上动脉夹角处的内径b及肾内段静脉内径C，并测量其相对应的血流峰值速度Va和Vb，通过简化柏努利方程计算左肾静脉与下腔静脉之间的压力差（Ap）。[结果]彩色多普勒超声可清晰显示NCS的解剖情况和血流动力学的变化，表现出受压狭窄处特征性的频谱形态改变，NCS组与对照组的a／b、C均有统计学差异（P〈0．05），而Ap有显著性差异（P〈0．01）。[结论]彩色多普勒超声可作为诊断NCS的首选方法，a／b内径比、C与△P的联合应用可明确诊断NCS。

Value of Color Doppler Ultrasound in the Diagnosis of Nutcracker Syndrome

[Objective]To explore the clinical value of color Doppler ultrasound in the diagnosis of Nut cracker syndrome（NCS）. [Methods]Color Doppler ultrasound on various body position was used to measure the inner diameter of proximal left renal vein（a）, inner diameter of the included angle between transabdomial a orta and superior mesenteric artery（b） and inner diameter of the vein inside kidney（c） in NCS group（ n =49） and healthy control group（ n ~ 50）. The corresponding flow velocity peak Va and Vb were also measured. The difference of pressure（AP） between left renal vein and inferior vena cava was calculated by using simplified Bernoullis equation. [Results] The anatomical features and the hemodynamic change of NCS could be clearly observed by color Doppler ultrasound and showed distinctive changes of frequency spectrum form on com pressed stenosis point. There was statistical difference in a/b and c between NCS group and control group（ P %0.05）, and there was significant difference in AP between them（ P %0.01）. [Conclusion]Color Doppler ul trasound can be used as the preferred method for clinical diagnosis of NCS. The combination of the ratio of in ner diameter（a/b）, c and AP can definitely diagnose NCS.