Hemodynamics With Color Doppler Ultrasound In The Nutcracker Phenomenon

Objective: Application of color Doppler ultrasound hemodynamic nutcracker phenomenon of research to explore the ultrasonic diagnosis of hemodynamic parameters.Materials and Methods: in our hospital from May 2007 to November 2008 a high degree of clinical suspicion between the nutcracker phenomenon, as 30 cases of patients in experimental group, and in my trip home, or outside the hospital or left renal vein contrast CT or MRI examination, proved to be the existence of left renal vein compression, elect the 20 cases confirmed by the non-nut-cracker phenomenon as a normal control group. Were used to detect the experimental group and control group, supine position when the left renal vein compression section diameter of the expansion of paragraph a, b, left renal vein peak velocity pressure above Va, the pressure gradient (ΔP), pressure (P), as well as the expansion of left renal vein peak velocity Vb paragraph and to observe the two forms of the spectrum, and then testing all the main subjects with renal renal artery, interlobar artery and renal blood flow velocity of the main renal artery resistance index; record of the experimental group urine test subjects in the number of red blood cells. On the comparative analysis of statistical parameters to evaluate the significance and value of clinical diagnosis.Results:1. Experimental group left renal vein blood back to the existence of obstacles to the phenomenon, as compared with the control group: the expansion of left renal vein diameter above paragraph b with the diameter of a compression ratio increased (P <0.05), peak velocity pressure Va paragraph by faster (P <0. 05), pressure above the pressure gradient (ΔP), pressure (P) increased (P <0. 05), the expansion of Vb paragraph slower peak velocity (P <0. 05). Paragraph left renal vein compression and expansion, respectively, above the spectrum was "pulse" of the spectrum, "platform-like" spectrum..2. The experimental group: left main renal artery, interlobar artery peak systolic velocity, diastolic peak velocity slower than the contralateral (P <0.05), left main renal artery resistance index higher than the contralateral (P <0.05); controls the main left renal artery, interlobar artery peak systolic velocity, diastolic peak velocity than the contralateral non-significant change (P> 0.05), left main renal artery resistance index no significant changes over the contralateral (P>0.05).3. After statistical analysis, computing, in patients with nutcracker phenomenon supine position when the pressure above the threshold value: Va≥0.9m/s,ΔP≥2.97mmHg, P≥5.97mmHg (1mmHg = 0. 133 kPa), Vb≤0. 14m/s; patients with nutcracker phenomenon of left renal main renal artery, interlobar artery peak systolic velocity, diastolic peak velocity slower than the contralateral, left main renal artery resistance index higher than the contralateral ; nutcracker phenomenon in the urine of patients with red blood cell expansion in the number of paragraphs and left renal vein, compression ratio above significant correlation does not exist.Conclusion:1. Nutcracker phenomenon of left renal vein in patients with lesions to the expansion of multi-paragraph paragraph diameter diameter ratio and pressure increase, blood pressure above speed, pressure and pressure gradient increased, slow down the expansion velocity paragraph, paragraph pressure , the expansion of the spectrum, respectively, were above "pulse" of the spectrum, "platform-like" characteristics of the spectrum for the ultrasonic diagnosis.2. Nutcracker phenomenon in patients with left main renal artery, interlobar artery peak velocity, diastolic velocity slower than the contralateral, left main renal artery resistance index higher than the contralateral.3. For clinically recurrent hematuria and proteinuria in patients, especially for reasons unknown, and the patients were long and thin body type, consideration should be given nutcracker phenomenon color Doppler ultrasound diagnosis of nutcracker phenomenon is a simple, reliable, repetitive non-invasive means. Patients with nutcracker phenomenon of left renal vein pressure above arterial blood pressure and renal hemodynamic changes in the ultrasonic diagnosis is a good indicator of nutcracker phenomenon.