目的 分析后胡桃夹综合征患者彩色多普勒超声表现,探讨彩色多普勒超声检查对后胡桃夹综合征的诊断价值.方法 回顾性分析8例经临床和相关检查确诊的后胡桃夹综合征患者的超声声像图.应用彩色多普勒超声检查观察左肾静脉的形态、走行,测量腹主动脉后方狭窄处和腹主动脉左侧扩张处左肾静脉的前后径、血流速度,计算狭窄处与扩张处的内径和血流速度比值.结果 彩色多普勒超声可清晰显示左肾静脉自肾门处注入下腔静脉的全程.本组8例胡桃夹综合征患者经多角度、多切面扫查均见左肾静脉穿越腹主动脉后方与腰椎之间隙汇入下腔静脉,狭窄处左肾静脉内径为(1.5±0.4)mm,血流速度为(154.5±30.1)cm/s;扩张处左肾静脉内径为(8.7±1.4)mm,血流速度为(22.8±3.4)cm/s;左肾静脉内径、血流速度比值分别为1:(6.5±0.5)及1:(7.2±0.9).结论 彩色多普勒超声检查可准确评价左肾静脉走行变异导致的左肾静脉扩张及血流动力学变化,对临床诊断、治疗后胡桃夹综合征具有重要的应用价值.%Objective To investigate the value of color Doppler ultrasound in the diagnosis of posterior nutcracker syndrome ( PNCS ) by analyzing the ultrasonographic data. Methods Eight cases diagnosed as PNCS according to history and examinations results were performed color Doppler ultrasound. The morphology and pathway of the left renal vein( LRV )were observed. After that, the anteroposterior diameter of LRV and peak velocity were measured both at the dialated portion on the left side of aorta and the narrowest segment between aorta and lumber vertebral. The ratios of both the diameter and the peak velocity were calculated later. Results Color Doppler ultrasound can clearly display the pathway of LRV running into the inferior vena cava. In all the 8 cases, LRV was demonstrated to flow into the inferior vena cava retroaortically by color Doppler ultrasound in multiple scanning planes. The diameter of the narrowest portion of the LRV was ( 1.5 ±0.4 )mm with the peak velocity of ( 154.5 ±30. 1 )cm/s,whereas the diameter of the dilated portion was ( 8. 7 ± 1.4 )mm with the peak velocity of ( 22. 8 ± 3. 4 )cm/s. The ratio of the diameter and the peak velocity between the narrowest portion with the dilated portion of the LRV were l:(6.5±0.5) and 1: ( 7. 2 ± 0. 9 ) respectively. Conclusion Color Doppler ultrasound could evaluate accurately the hemodynamic changes due to left renal vein anomalies and is useful for the diagnosis and management of PNCS.
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