Objective To study the effect of ultrasound in the diagnosis of the nutcracker syndrome, so as to optimize examination process. Methods Fifty-five NCS were collected as the observation group, forty-one healthy patients were included in the control group. These two groups were in the supine position, dorsal extension (divided into four groups: 0 min-5 min, 5 min-10 min, 10 min-15 min, and 15 min-20 min). In calm breathing, end of inhalation and end of breath, 2D ultrasound and spectral Doppler measuring angle (θ), inner diameter (D1), distal heart inner diameter (D2), peak flow velocity (PVN), distal heart peak flow velocity (PVD) and other parameters were recorded and they were performed a comparative analysis. Results In the observation group, the D2/D1 of dorsal extension of the spine for 15 min-20 min and when calm breathing was slightly greater than that of 5min-10min and 10min-15min (P<0.05). However, the diagnostic sensitivity differences among the three time periods are not significant, and there was no statistically significant difference in D2/D1 between the above four time periods. Inhalation during the test resulted in a decrease in angle θ and an increase in D2/D1, and exhale was the opposite. Conclusions In the course of examining patients with nutcracker syndrome, the length of back extension has little effect on the examination results, ultrasound in the process of examination in patients with nutcracker syndrome, inhale can lead to positive rate increase, breathing out can lead to positive rate decline, and the positive rate is in the middle when breathing calmly. Therefore, the back extension time can be shortened during the inspection process, then tell the patients not to inhale or exhale, try to calm breathing in the examination.
Key words
Ultrasonography /
/
/
Doppler /
/
/
Nutcracker syndrome /
/
/
Left renal vein /
/
/
Dorsal extension
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 彭悦, 李秋. 胡桃夹综合征的临床表现与检查[J]. 儿科药学杂志, 2016, 22(12): 56-59. DOI: 10.13407/j.cnki.jpp.1672-108X.2016.12.020.
Peng Y, Li Q. Clinical manifestations and diagnostic methods of nutcracker syndrome[J]. Journal of Pharmacy in Pediatrics, 2016, 22(12): 56-59. DOI: 10.13407/j.cnki.jpp.1672-108X.2016.12.020.
[2] 刘小琨, 吕剑龙, 陆华萍, 等. 完全主动脉后型左肾静脉变异的CT表现[J]. 中国中西医结合影像学杂志, 2017, 15(1): 50-52. DOI: 10.3969/j.issn.1672-0512.2017.01.017.
Liu XK, Lü JL, Lu HP, et al. CT imaging features of complete posterior type left renal vein variants[J]. Chinese Journal of Integrative Imaging in Medicine, 2017, 15(1): 50-52. DOI:10.3969/j.issn.1672-0512.2017. 01.017.
[3] 卜凡文, 陈慧霞, 姜莉, 等. 胡桃夹综合征合并肾脏器质性病变的超声诊断与临床研究[J]. 中国中西医结合影像学杂志, 2015, 13(5): 518-520. DOI: 10.3969/j.issn.1672-0512. 2015.05.015.
Bu FW, Chen HX, Jiang L, et al. Ultrasound diagnosis and clinical study of combined nutcracker syndrome and renal structural abnormalities[J]. Chinese Journal of Integrative Imaging, 2015, 13(5): 518-520. DOI: 10.3969/j.issn.1672-0512.2015.05.015.
[4] 张晓东, 林锦蓉, 张佐炳, 等. 影像学诊断胡桃夹综合征进展[J]. 中国医学影像技术, 2019, 35(6): 942-945. DOI: 10.13929/j.1003-3289. 201811017.
Zhang XD, Lin JR, Zhang ZB, et al. Progress in imaging diagnosis of hiatal hernia syndrome[J]. Chinese Journal of Medical Imaging Technology, 2019, 35(6): 942-945. DOI: 10.13929/j.1003-3289. 201811017.
[5] 胡元平, 霍兰, 吴琪, 等. 不同体位超声检查对胡桃夹现象的诊断意义[J]. 中华超声影像学杂志, 2004, 13(2): 62. DOI: 10.3760/j.issn:1004-4477.2004.02.020.
Hu YP, Huo L, Wu Q, et al. The diagnostic significance of different posture ultrasound examinations for waist compression syndrome[J]. Journal of Ultrasound in Medicine, 2004, (2):62. DOI: 10.3760/j.issn:1004-4477.2004.02.020.
[6] 中国医师协会超声医师分会. 血管超声检查指南[J]. 中华超声影像学杂志, 2009, 18(11): 993-1012. DOI: 10.3760/cma.j.issn.1004-4477. 2009.11.030.
Chinese Medical Doctor Association, Division of Ultrasound Physicians. Guidelines for vascular ultrasound examination[J]. Journal of Ultrasound in Medicine, 2009, 18(11): 993-1012. DOI: 10.3760/cma.j.issn.1004-4477.2009.11.030.
[7] 孟凡荣, 陈松旺, 陆建平, 等. 胡桃夹综合征超声诊断标准的研究[J]. 临床超声医学杂志, 2006, 8(12): 739-742. DOI: 10.3969/j.issn.1008-6978.2006.12.012.
Meng FR, Chen SW, Lu JP, et al. Investigation of diagnostic standards of nutcracker syndrome with ultrasound[J]. Journal of Clinical Ultrasound, 2006, (12): 739-742. DOI: 10.3969/j.issn.1008-6978. 2006.12.012.
[8] 高攀, 李宁, 郭淑芬, 等. 吸气努力对下腔静脉内径变异度的影响[J]. 中国呼吸与危重监护杂志, 2024, 23(7): 465-469. DOI: 10.7507/1671-6205.202403033.
Gao P, Li N, Guo SF, et al. Effects of inspiratory effort on inferior vena cava diameter variability[J]. Chin J Respir Crit, 2004, 23 (7): 465-469. DOI: 10.7507 / 1671-6205.202403033.
[9] Suh, Ga-Young, Choi，et al. Three-dimensional modeling analysis of visceral arteries and kidneys during respiration[J]. Ann Vasc Surg, 2016, 34: 250-260. DOI: 10.1016/j.avsg.2016.04.004.
[10]Anna F, Marco B, Paolo P, et al. Vena cava responsiveness to controlled isovolumetric respiratory efforts[J]. J Ultrasound Med, 2017, 36(10): 2113-2123. DOI: 10.1002/jum.14235.
[11]Mesin L, Giovinazzo T， D'Alessandro S, et al. Improved repeatability of the estimation of pulsatility of inferior vena cava[J]. Ultrasound Med Biol, 2019,45(10):2830-2843. DOI: 10.1016/j.ultrasmedbio.2019. 06.002.
[12]Cheyne SW, Gelinas CJ, Eves DN, et al. The haemodynamic response to incremental increases in negative intrathoracic pressure in healthy humans[J]. Exp Physiol, 2018, 103(4): 581-589. DOI: 10.1113/EP086654.
[13]张彦, 牟楠楠, 王惠, 等. 彩色超声多普勒结合超声造影诊断胡桃夹综合征[J]. 中国医学影像技术, 2011, 27(1): 171-174. DOI: 10.13929/j.1003-3289.2011.01.005.
Zhang Y, Mu NN, Wang H, et al. Diagnosis of compression syndrome of the renal artery using color doppler ultrasound and contrast-enhanced ultrasound[J]. Chinese Journal of Medical Imaging Technology, 2011,27(1): 171-174. DOI: 10.13929/j.1003-3289. 2011. 01.005.
PDF(2716 KB)
