【摘要】 目的探讨二维及彩色多普勒超声对左肾静脉压迫综合征检测的临床价值。方法利用二维(2D)彩色多普勒血流显像(CDFI)及脉冲多普勒(PW)检测38例左肾静脉压迫综合征患者,观测仰卧位及右侧卧位其管腔内径、CDFI、PW频谱变化。结果38例患者左肾静脉均见不同程度受压变窄,内径(0.21±0.09)cm;压迫前扩张,内径(0.99±0.41)cm,与前者之比≥3,CDFI示血流色彩暗淡,PW呈低速连续性频谱;压迫后血流色彩明亮或混叠,呈高速湍流脉动频谱,右侧卧位压迫解除,压迫前管径回缩,血流速度增快,呈下腔静脉样脉动频谱,各测值与仰卧位比较P<0.01,有极显著差异。1例老年患者狭窄前扩张处见附壁絮状物回声。结论二维及彩色多普勒超声是检测左肾静脉压迫综合征有效、可靠的首选方法,右侧卧位对改善左肾血流动力学状态,指导临床有重要意义。更多还原

【Abstract】 Objective To evaluate the clinical value of two-dimensional and color Doppler ultrasound in the diagnosis of left renal vein entrapment syndrome.Methods A total of 38 cases with left renal vein entrapment syndrome underwent two-dimensional ultrasound (2D),color Doppler flow imaging (CDFI) and pulsed wave Doppler (PW).The changes of the diameter and frequency spectrum of CDFI and PW on dorsal position and right lateral recumbent position were observed.Results Left renal vein stricture with different extent across the inclination between abdominal aorta and superior mesenteric artery were present in all 38 cases with diameter 0.21±0.09 cm,The veins were wide before compression with diameter 0.99±0.41 cm.CDFI showed that the color blood flow was faint,PW showed low speed continuous spectrum with average speed of 9.48±2.43 cm/s.The color blood flow was bright or aliaising after compression and showed high speed turbalent spectrum with average of 78.26±15.84 cm/s.When the patients lying on the right lateral recumbent position the compression was relieved.The pipe diameter was retracted.The blood flow velocities were quickened and showed pulsatile spectra like that of inferior vena cava.There were significant differences in all values compared with those on dorsal position,P<0.01.Flocculent echoes attached on the dilated position before the stricture in one old patient.Conclusions 2D plus color Doppler ultrasound is an effective and reliable method in diagnosing left renal vein entrapment syndrome.Right lateral recumbent position has important meaning in improving the hemodynamic state of left renal vein and may give clinical guidance.更多还原