彩色多普勒超声对诊断胡桃夹现象实用价值.docVIP

彩色多普勒超声对诊断胡桃夹现象实用价值 　　[摘要] 目的 运用彩色多普勒血流显像（CDFI）及脉冲多普勒（PWD）观察扩张段和狭窄段的血流信号及血流频谱。方法 无需特殊准备，但最好于空腹时检查，先用二维超声找到腹主动脉（AO）和肠系膜上动脉（SMA）分支时所形成的夹角及横跨其的左肾静脉（LRV），估测其夹角及左肾静脉扩张段和狭窄段的内径。结果 肠系膜上动脉与腹主动脉之间的夹角＜9°可作为诊断参考，左肾静脉内径扩张段/狭窄段＞2～3有诊断学意义。结论 彩色多普勒血流显像能较客观地体现此三只血管的解剖关系及血流动力学的相关指数，应作为诊断此病的首选方法之一。 　　[关键词] 胡桃夹现象；彩色多普勒超声；脉冲多普勒 　　[中图分类号] R445.1；R692 [文献标识码] B[文章编号] 1673-9701（2011）27-112-02 　　 　　The Practical Value of Color Doppler Ultrasound for Diagnosis of Nutcracker Phenomenon 　　YAN XiangqingXU Meihua 　　Department of Ultrasound, Hunchun Municipal Hospital in Jilin Province, Hunchun 133300, China 　　 　　[Abstract] Objective To observe blood flow and blood flow spectrum of the expansion and stenosis segments using color Doppler flow imaging（CDFI）and pulse wave Doppler（PWD）. Methods No special preparation was needed, but should check on an empty stomach. Firstly two-dimensional ultrasound was used to find the angle formed by branching of abdominal aorta（AO）and superior mesenteric artery（SMA）and the left renal vein（LRV）acrossing the angle, and estimated the angle and the diameters of expansion and stenosis segments of the left renal vein. Results The angle between the superior mesenteric artery and abdominal aorta ＜9°could be used as diagnostic reference, and diameter ratio of expansion and stenosis segments of the left renal vein ＞ 2 to 3 had diagnostic significance. Conclusion Color Doppler flow imaging can more objectively reflect the relationship between the three vascular anatomy and hemodynamics related index, should be the preferred method of diagnosis of the disease. 　　[Key words] Nutcracker phenomenon；Color Doppler ultrasound；Pulse wave Doppler 　　 　　本文应用二维超声及彩色多普勒超声和脉冲多普勒技术对多见于傍晚或运动后的或发作性或持续性肉眼或镜下无症状性、直立性血尿或蛋白尿的31例患者做了回顾性分析、总结，现报道如下。 　　1 资料与方法 　　本组的31例患者均为我院2002～2010年的门诊患者，年龄4～17岁，其中男23例，女8例，均以傍晚或运动后、或发作性或持续性肉眼或镜下无症状性、直立性血尿或蛋白尿，偶伴肋痛、不规则月经、高血压等症状来我院就诊，在排除先天性肾畸形、外伤、肿瘤、结石、感染等疾病的前提下，重点倾向于本病的彩色多普勒超声检查。使用仪器为Toshiba SSH140A和Philips飞凡影像彩色多普勒显像仪，使用探头频率为3.5MHz的凸阵探头，扫描角度为60°～