浅析螺旋CT在诊断胡桃夹综合征中的应用

摘要

目的:探讨螺旋CT(SCT)三维重建技术诊断胡桃夹综合征的价值.方法:运用螺旋CT对22例胡桃夹综合征患者泌尿系统进行多期增强扫描,同时用自带软件进行必要的后处理.结果:22例病例均可见肠系膜上动脉(SMA)压迫左肾静脉(LRV)的征象.螺旋CT多平面重建(MPR)技术可直观地显示腹主动脉(AO)与SMA之间的夹角(α) 15.23°～28.45°,平均19.90°.左肾静脉受压前管腔直径与受压处管径之比为2.48 1:～ 8.3 21.6例腹主动脉前壁见有弧形压迹,7例左肾静脉上方肠系膜上动脉可见弓形隆起,9例左肾静脉上下径拉长,最长达18.98mm.15例增强扫描肾实质期(后期)显示双肾实质密度相差20HU以上.结论:SCT在胡桃夹综合征诊断中具有明显的优势.%Purpose: To investigate the value of spiral CT (SCT) three-dimensional reconstruction technology in the diagnosis of nutcracker syndrome. Methods: Enhancement scanning of urinary system was performed in twenty-two patients with nutcracker syndrome by spiral CT, and the images were post-processed with 3d reconstruction software. Results: All the patients with nutcracker syndrome displayed the signs of left renal vein (LRV) compressed by superior mesenteric artery (SMA). The spiral CT multi-planar reconstruction (MPR) intuitively showed that the angles (a) between abdominal aorta (AO) and SMA were from 15.23° to 28.45°, with the average of 19.90°. The ratios of lumens diameter of LRV before and after the compressed point were 2.48-8.32:1. The anterior wall of the aorta was shown with arc impression in 6 patients, arch eminence of the SMA above LRV was shown in 7, and the length extended of the LRV was shown in 9,with the maximum length of 18.98 mm. The difference between two renal parenchyma density above 20 HU was shown in 15 patients during enhancement scanning. Conclusion: Spiral CT has obvious superiority in the diagnosis of nutcracker syndrome.