【摘要】 目的分析彩色超声多普勒血流成像(CDFI)及超声造影诊断胡桃夹综合征(NCS)的临床应用价值。方法 以80例临床疑诊NCS患者(病变组)及40例健康人群(对照组)为研究对象,应用CDFI检查测量肠系膜上动脉(SMA)与腹主动脉(AO)间夹角(β),动态测量CDFI及造影后左肾静脉(LRV)近端扩张段(a)、受压段(b)前后径Da和Db,峰值流速Va和Vb,计算Da/Db、Vb/Va。80例疑诊NCS患者中超声造影17例。结果 ①病变组诊断NCS40例,其中结合超声造影诊断15例。平卧位β值约(28±11)°,站立位20min后约(19±9)°,两体位间差异有统计学意义(P<0.01)。对照组平卧位β值约(48±14)°,站立位20min后约(37±12)°,两体位间差异有统计学意义(P<0.05)。病变组与对照组比较差异有统计学意义(P<0.01)。②CDFI检查:病变组平卧位及站立位20min后b处均明显受压,两体位间Da/Db和Vb/Va差异有统计学意义(P均<0.001);b处LRV呈五彩镶嵌血流,流速增高,a处血流束黯淡,流速减低,血流随呼吸变化幅度小。超声造影后,于静脉相更清晰显示LRV受压情况,15例诊断NCS患者Da/Db、Vb/Va与CDFI检查平卧位比较差异有统计学意义(P均<0.001),与站立位20min后比较差异不明显(P>0.05)。对照组平卧位及站立位20min后均无明显受压,病变组Da/Db、Vb/Va与对照组比较差异有统计学意义(P均<0.001)。结论 CDFI结合超声造影可明确诊断NCS。更多还原

【Abstract】 Objective To analyze the clinical application of color Doppler flow imaging(CDFI) and contrast-enhanced ultrasonography in diagnosis of nutcracker syndrome(NCS).Methods Totally 80 patients clinically suspected as NCS underwent CDFI(patient group),of which 17 patients were inspected with contrast-enhanced ultrasonography.And we choosed 40 cases of healthy to be control group(P<0.01).The angle(β) between superior mesenteric artery(SMA) and abdominal aorta(AO),the interior diameter(Db,Da) of compression(b) and the proximal expansion(a) section of left renal vein(LRV),as well as the flow velocity Va and Vb were measured.Da/Db and Vb/Va were calculated.Results ①There were 40 NCS diagnosised with CDFI in patient group,of which 15 were diagnos ed combining with contrast-enhanced ultrasonography.The angle β with horizontal supines was(28±11)° and(19±9)° with standing supines 20 min(P<0.01).And it was(48±14)° and(37±12)° in control group(P<0.05).There was significant differece in patient group compared with control group.②LRV was significantly compressed in horizontal supines and standing for 20 min at patient group,Da/Db and Vb/Va were statistically different in both position(all P<0.001).The blood flow velocity at proximal expansion(a) reduced,while there was a colorful mosaic at b.The diameter and velocity of LRV were clearly showed with contrast-enhanced ultrasonography in vein phases.There was significant difference for Da/Db,Vb/Va compare with horizontal supines(all P<0.001),but not significant difference compare with those of standing for 20 min(P>0.05).It was not compressed in horizontal supines and standing for 20 min in control group.There were significant difference for Da/Db,Vb/Va in patient group compared with control group(P<0.001).Conclusion NCS can be accurately diagnosed with CDFI combining with contrast-enhanced ultrasonography.更多还原