三种超声方法评价左肾静脉受压综合症的价值

目的探讨二维超声(2D)、彩色多普勒血流显像(CDFI)和脉冲多普勒(PD)诊断左肾静脉受压综合症(Nut-CrackerSyn-drome,简称NCS)的价值。方法应用PHILIPS公司生产的IU22及HDI5000彩色多普勒超声诊断仪检测临床出现血尿、蛋白尿,而肾功能正常的患儿50例。2D测量主动脉左侧左肾静脉扩张段内径(A)和主动脉前方左肾静脉受压段内径(B),计算A/B比值;CDFI观察左肾静脉扩张段和受压段彩色血流色差;PD测量左肾静脉扩张段流速(Va)和受压段流速(Vb)并计算Va/Vb比值。8例得到肾静脉造影证实,4例经增强CT证实,3例经MRI证实。结果15例得到其他影像学证实的患儿中,站立位2D诊断NCS12例,CDFI诊断NCS13例,PD诊断NCS12例。2D CDFI阳性例数为14例,2D PD阳性例数为14例,2D CDFI PD阳性例数为15。结论3种超声方法综合判断NCS可提高诊断符合率。

Value of three ultrasound methods in evaluating Nut-cracker syndrome

Objective To evaluate Nut-Cracker Syndrome (NCS) with two-dimensional ultrasound (2D),color Doppler flow imaging (CDFI) and pulse Doppler (PD). Methods All 50 children patients with hemuresis, proteinuria, and normal renal function, were examined with 2D, color Doppler sonography and PD. The diameter and velocity and restricted part of left renal vein(LRV) were measured. The final diagnosis was confirmed by renal vein angiography in 8 cases, by enhanced CT in 4 cases, and by MRI in 3 cases. Results NCS was diagnosed in 12 cases by 2D only, in 13cases by CDFI only, and in 12 cases by PD only. NCS was diagnosed in 14 cases by 2D and CDFI,in 14 cases by 2D and PD,and in 15 cases by 2D, CDFI and PD. Positive rate was more in standing position than that supine position. Conclusion Nut-cracker syndrome can be diagnosed by the Combination of 2D, CDFI and PD.