不同影像学方法诊断左肾静脉压迫综合征的比较

目的 比较不同影像学方法诊断左肾静脉压迫综合征(LRVES)的价值。 方法 收集接受二维超声和断层超声显像(TUI)检查的50例无痛性血尿、蛋白尿患者,其中30例接受CT检查;测量患者近肾端最宽处左肾静脉和腹主动脉与肠系膜上动脉间最窄处左肾静脉内径比值及肠系膜上动脉与腹主动脉间夹角。以血管造影为金标准,评价上述方法LRVES的敏感度与特异度。 结果 二维超声诊断LRVES敏感度和特异度分别为78.05%(32/41)和77.78%(7/9);通过测量左肾静脉扩张段与狭窄段内径比和肠系膜上动脉与腹主动脉间夹角,TUI诊断LRVES的敏感度分别为95.12%(39/41)和92.68%(38/41),特异度为88.89%(8/9)和88.89%(8/9),均高于二维超声;CT诊断敏感度和特异度分别为95.00%(19/20)和90.00%(9/10),高于二维超声,与TUI相似。 结论 TUI无辐射,诊断LRVES敏感度及特异度高,较二维超声及CT更具临床意义。

Comparison of different imaging methods in diagnosis of left renal vein entrapment syndrome

Objective To explore the value of different imaging methods in diagnosis of left renal vein entrapment syndrome (LRVES). Methods Totally 50 patients with painless gross hematuria and proteinuria underwent two-dimensional ultrasound (2DUS) and tomographic ultrasound imaging (TUI), while 30 of them underwent CT scan. The diameter ratio of the dilated part to the narrowed part of left renal vein and the angle between the aorta and the superior mesenteric artery was measured, the sensitivity and specificity of different methods were compared. Results The sensitivity and specificity of 2DUS was 78.05% (32/41) and 77.78% (7/9), respectively. Through measurement of the diameter ratio of the dilated part to the narrowed part of left renal vein and the angle between the aorta and the superior mesenteric artery, the sensitivity of TUI was 95.12% (39/41) and 92.68% (38/41), and the specificity was 88.89% (8/9) and 88.89% (8/9), respectively, all higher than those of 2DUS. The sensitivity and specificity of CT (95.00% and 90.00% ) were higher than those of 2DUS, similar to those of TUI. Conclusion TUI has high sensitivity and specificity in diagnosis of LRVES, which is more valuable compared with 2DUS and CT.