The value of multi-detector CT in diagnosis of nutcracker syndrome and nutcracker phenomenon
Objective To investigate the value of Multidetector CT(MDCT)scan in the diagnosis of Nutcracker syndrome(NCS)and Nutcracker phenomenon(NCP).Methods Twenty-two patients were included in this retrospective study from January 2018 to June 2024.including 13 NCS patients and 9 NCP patients.The clinical manifestations and the CT features in different groups were analyzed.The visibility of SMA and LRV on unenhanced CT was evaluated.On the enhanced CT reconstraction images,the aortomesenteric angle(AMA),the anteroposterior diameter of the widest point of the proximal left ranal vein(D1),the anteroposterior diameter at the AMA(D2),and the D1/D2 ratio were measured.Results SMA and LRV of adults are visible on unenhanced CT scan.The AMA,D1,D2,D1/D2 in NCS group(13 cases)were 15.14°±3.54°,11.00±2.38mm,2.76±0.43mm,4.08±1.19,and the NCP group were 22.42°±4.97°,10.55±1.66mm,4.00±0.70mm,2.70±0.53,respectively.There was a significant difference(P<0.05)of AMA,D2,D1/D2 values between NCS group and NCP group.Conclusion Unenhanced MDCT is capable of suggesting or exclu-ding the diagnosis of NCS or NCP,while enhanced MDCT can provide a comprehensive assessment of abdominal vascular morphology and the collateral circulation of the LRV,allowing for a difinitive diagnosis of NCS when combined with clinical information.
Left renal vein entrapment syndromeNutcracker phenomenonNutcracker syndromeMultidetector CT