本文選題：“胡桃夾”綜合征 + 腸系膜上動(dòng)脈　； 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的 應(yīng)用多層螺旋CT(MSCT)及后處理技術(shù)研究正常左腎靜脈(left renal vein, LRV)、腸系膜上動(dòng)脈(superior mesenteric artery,SMA)與腹主動(dòng)脈(abdominal aorta, AA)夾角的解剖形態(tài)學(xué)規(guī)律,探討MSCT診斷“胡桃夾”綜合征(nutcracker syndrome, NCS)的臨床應(yīng)用價(jià)值。 方法 采用64排MSCT,前瞻性觀察220例正常者的SMA與AA的夾角大小,LRV最窄處、近腎門段最寬處的內(nèi)徑(前后徑)及相應(yīng)水平的截面積,以明確LRV的走行特征及正常人SMA與AA夾角的大小對(duì)LRV形態(tài)的影響,并計(jì)算出正常人SMA與AA夾角的范圍LRV受壓前后的內(nèi)徑、截面積的參考范圍以及體重指數(shù)與夾角的關(guān)系。圖像后處理技術(shù)包括多平面重組(multi-planar reformation, MPR)、最大強(qiáng)度投影(maximum intensity projection, MIP)。另有3例臨床已證實(shí)NCS的病例作為分析參考。 結(jié)果 220例正常SMA與AA的夾角的大小為56.67±18.27。,腎門段LRV前后徑(DD)為9.91±2.23mm,截面積(SAD)為119.81±43.03mm2；夾角段LRV前后徑(DN)為6.50±2.31mm,截面積(SAN)為86.47±41.27mm2；并計(jì)算DD/DN,SAD/SAN。220例正常人中體重指數(shù)(body mass index, BMI,Kg/m2)與SMA與AA間的夾角不具有明顯的相關(guān)性,但是有一定的正相關(guān)聯(lián)系。 結(jié)論 正常人LRV于SMA夾角處呈所謂輕度受壓征象(移行型或夾角小于50。)是一種普遍存在的正常現(xiàn)象。NCS是一個(gè)以臨床癥狀為前提的綜合診斷,不能單純依靠CT表現(xiàn)確診NCS,但CT表現(xiàn)可提示患NCS的可能性大小。當(dāng)LRV呈未受壓型或移行型,SMA夾角大于50。,截面積縮小在Ⅱ度以下,可排除NCS的可能；LRV呈漏斗型,夾角小于50。,截面積縮小達(dá)Ⅱ度以上者,高度可疑NCS,應(yīng)結(jié)合臨床癥狀進(jìn)一步檢查確診。
[Abstract]:PurposeThe anatomical morphology of left renal vein (LRV), superior mesenteric mesenteric artery (SMA) and abdominal aorta (AAA) in normal left renal vein were studied by multislice spiral CT (MSCT) and postprocessing technique. The clinical application value of MSCT in the diagnosis of nutcracker syndrome (NCSs) was discussed.MethodThe angle between SMA and AA and the inner diameter (anteroposterior diameter) near the widest part of the hilar segment and the corresponding sectional area were observed prospectively by 64 row MSCT in 220 normal subjects.In order to clarify the characteristics of LRV and the influence of the angle between SMA and AA on the morphology of LRV, the inner diameter, the reference range of cross section and the relationship between the body mass index and the angle of LRV were calculated before and after the compression of the angle between SMA and AA in normal people.Image post-processing techniques include multi-planar recombination multi-planar reform, MPRA, maximum intensity projection maximum intensity project, MPRA.Another 3 cases of clinically confirmed NCS were used as a reference for analysis.ResultThe angle between normal SMA and AA was 56.67 鹵18.27 mm, the anterior and posterior diameter of renal hilar LRV was 9.91 鹵2.23 mm, the cross section area was 119.81 鹵43.03 mm-2, the angle segment of LRV anterior and posterior diameter was 6.50 鹵2.31 mm, and the cross section area was 86.47 鹵41.27 mm, and the body mass index (BMI) between SMA and AA was calculated.There is no obvious correlation between the angles,But there is a positive correlation.ConclusionIn normal subjects, LRV showed so-called mild compression at the angle of SMA (transference or angle less than 50. 0).NCS is a common normal phenomenon. NCS is a comprehensive diagnosis based on clinical symptoms. It can not be diagnosed solely by CT findings, but CT findings can indicate the possibility of NCS.When the angle of LRV is greater than 50. The cross section area is smaller than 鈪，

本文編號(hào)：1772322