【摘要】 目的 探讨640层容积CT灌注成像诊断胡桃夹综合征（nutcracker syndrome,NCS）左肾静脉受压及左、右肾血流动力学改变的价值。方法 12例临床诊断为NCS的患者行双肾全器官CT灌注成像,其动态容积数据作为病人组;20例无肾脏疾病、肾血管正常的患者作为对照组被回顾性分析。采用Body Perfusion软件进行灌注成像分析,测量左、右肾皮质的灌注值。采用配对样本t检验分别对NCS组左、右肾皮质灌注值和对照组左、右肾皮质灌注值进行比较;NCS组与对照组之间的左、右肾皮质灌注值比较采用独立样本t检验。结果 NCS组左、右肾皮质灌注平均值分别为350.8 mL·min^-1·100 mL^-1和391.1 mL·min^-1·100 mL^-1,左肾皮质的灌注值较右肾皮质明显降低,平均下降39.4 mL·min^-1·100 mL^-1,两者比较有明显差异（t=4.204,P<0.01）。对照组左、右肾皮质灌注平均值分别为263.8 mL·min^-1·100 mL^-1和266.3 mL·min^-1·100 mL^-1,两者比较无明显差异（t=0.440,P>0.05）。NCS组和对照组左肾皮质灌注值（t=4.433,P<0.05）,NCS组和对照组右肾皮质灌注值（t=7.114,P<0.05）均有统计学差异。结论 全器官肾灌注成像作为一种评价器官血流灌注状态的功能成像技术,能准确地反映NCS早期左肾血流动力学的改变,为量化诊断NCS和临床干预治疗提供理论依据。更多还原

【Abstract】 Objective To investigate the left renal homodynamic change and compressions of left renal vein in nutcracker syndrome（NCS） with CT perfusion by using 640-slice CT.Methods Twelve cases clinically diagnosed as NCS（patient group） were performed whole-organ perfusion of the kidneys with 640-slice CT.Twenty subjects（control group） with normal kidneys and renal vessels were retrospectively reviewed.CT perfusion were applied to measure the perfusion values in bilateral renal cortex using body perfusion software.The differences of perfusion values between right and left renal cortex in patient group and control group were evaluated using paired t-test,and the differences of right and left renal cortex among NCS group and control group were evaluated using independent t-test,respectively.Results There was significant difference between left and right renal cortex in NCS group(350.8 mL·min^-1·100 mL^-1 and 391.1 mL·min^-1·100 mL^-1 respectively,t=4.204,P<0.01).Perfusion values of left renal cortex was significantly less than that of right renal cortex(the average was 39.4 mL·min^-1·100 mL^-1).In the control subjects,the mean perfusion values of left and right renal cortex were 263.8 mL·min^-1·100 mL^-1 and 266.3 mL·min^-1·100 mL^-1,respectively.There was no significant difference in bilateral renal cortex（t=0.440,P>0.05） in control group.There was significant difference in left renal cortex（t=4.433,P<0.05） between control group and NCS group,and there was also significant difference in right renal cortex（t=7.114,P<0.05）.Conclusion As a non-invasive method,640-slice CT perfusion accurately reveals homodynamic changes of left kidney in NCS,provide further potential of studying items,and useful for clinical treatment planning as well.更多还原