Tomographic Ultrasound Imaging To Diagnose The Left Renal Vein Entrapment Syndrome

Background The left renal vein usually crosses between the superior mesenteric arteryand the aorta. Due to some factors, the compression of the left renal vein is acquired,which results in the left renal vein hypertension, producing the left renal veinentrapment or nutcracker syndrome.Symptoms of LRVES commonly include hematuria,pain or gonadal vein syndrome, varicocele, orthostatic proteinuria, and orthostaticintolerance. It also contains left varicocele, chronic fatigue syndrome, pelvic congestionand so on. Conventional ultrasound has been used for a long time in the diagnosis of theLRVES. Conventional ultrasound, which is not expensive and available in mosthospitals, is not noninvasive for the patients and does not produce radiation to thebodies. However, the spatial resolution of conventional ultrasound is so low that thediagnostic accuracy is on the decrease.. In2DUS, only the LRV diameter was measured,however, in TUI, not only the D/N ratio but also the AMA was measured and the D/Nratio was calculated.These shortcomings have called for an arrival of another diagnostic instrument. TUI isa fast clinical US diagnostic instrument and noninvasive. Not only is the spatialresolution higher, but also the depth-of-field and the contrast are superior toconventional ultrasound[8].Some recent studies have demonstrated that TUI has a highaccuracy in the diagnosis of breast and fetal heart disease.The principle of tomographic ultrasound imaging was volume ultrasound. The depthand interval of section could be adjusted, and the min accuracy could reach to0.1mmfor TUI. The demonstrated10cm depth-of-field is superior to that of conventionalultrasound and the image contrast is improved through the reduction of speckle noise and overall lowering of the noise floor. Furthermore, with the advent of ultrasoundtomography, sections of the LRV are now able to review in all three mutuallyperpendicular orthogonal planes. Already, a number of researchers have effectivelydemonstrated that TUI technology offers various advantages over conventionaltwo-dimensional imaging. It had the potential to improve diagnostic imaging inrelation to LRVES detection.Objective To compare various Imaging methods in diagnosis of left renal veinentrapment syndrome and to explore the significance of tomographic ultrasoundimaging in diagnosis of left renal vein entrapment syndrome.Methods Our study involved60random individuals, scanned in2DUS and TUI,50ofwhom were followed up. Meanwhile,30random individuals were examined by CT,30of whom were followed. The angle between the aorta and the superior mesentericartery or the ratio of the diameter of the dilated part of the LRV to that of the narrowedpart of the same vein was measured, and the sensitivity and specificity were counted.The figure score was compared between2DUS and TUI. AT the same time, thecorrelation was compared between the BMI and the AMA or the D/N ratio.Results The inner diameter by TUI was statistically significant compared with2DUS.Although CT had increased sensitivity and specificity compared with2DUS and TUI,the AMA had not result in statistical significance between TUI and CT. The figurescore between TUI and2DUS was statistically significant. The correlation coefficient hadstatistical significance respectively between the BMI and the AMA or the D/N ratio.Conclusion The figure quality of TUI was better than2SUS.It is obvious that TUI wasmore applicable to diagnosing LRVES.