Study On The Diagnosis Of Nutcracker Syndrome By Multislice Spiral CT Angiography

Objectives:To analyze and discuss the imaging features and clinical application of multi-slice spiral CT angiography(MSCTA)in the diagnosis of Nutcracker Syndrome(NCS).Methods:We retrospectively analyzed the clinical data of 50 cases of clinically diagnosed Nutcracker Syndrome patients,namely the case group,and randomly selected 50 normal subjects at the same time as the control group,and compared the MSCT images of the two groups.To observe the MSCT performance and concomitant signs of the left renal vein(LRV)in patients with Nutcracker Syndrome(NCS);to measure the angle(?)between the superior mesenteric artery(SMA)and the abdominal aorta(AA)in the case group and the control group.The ratio of the anteroposterior diameter(D1)and cross-sectional area(S1)of the renal vein at the angle of the renal vein and the anteroposterior diameter(D2)and cross-sectional area(S2)at the widest part of the proximal renal end were calculated(D2/D1,S2/S1),and perform statistical analysis.Results:(1)In the case group,50 cases of NCS patients showed sharp angles of SMA from AA,and the angle between the two was significantly smaller;LRV ran between SMA and AA,and the LRV became narrower or thinner at the angles."Beak-like" "linear" stenosis,LRV near the renal end showed significant expansion,10 cases showed that the left side of the lumbar vein dilatation,8 cases can be seen on the left ovarian vein dilation,3 cases can be seen on the left spermatic vein expansion,2cases Visible left kidney enlargement,1 case with duodenal stasis syndrome.In the control group,there were two types of LRV changes in 50 normal subjects: The LRV gradually migrated from the portal vein to the inferior vena cava during the stroke,showing a natural streamline shape;LRV was slightly compressed and attenuated at the angle between the SMA and the AA.During this time there was a large fat gap around the LRV,and no LRV was found in the LRV cycle.(2)The two groups of measurement data(?,D1,D2,S1,S2,D2/D1,S2/S1)were compared and there was a difference(p<0.05).Conclusion:(1)The MSCTA can clearly show the specific shape and shape of the LRV,and can accurately measure the data.It is more intuitive to determine the stenosis of the LRV compression site,and can be used to observe the concomitant signs of the Nutcracker syndrome,which provide strong evidence for the diagnosis of replication.(2)If the angle between SMA and AA is ?35°,the LRV is funnel-shaped(D2?3D1),the reduction in LRV cross-sectional area is more than 50% on MSCT,patients develop clinical symptoms of hematuria,proteinuria,and left gonad varicosity and other symptoms of LRV,We should highly doubt NCS.The further diagnosis must be combined with other clinical comprehensive examinations.