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Nutcracker phenomenon: a new diagnostic method of multislice computed tomography angiography
Wei-Jun Fu1, Bao-Fa Hong, Jiang-Ping Gao
1Department of Urology, Chinese People's Liberation Army General Hospital, Military Postgraduate Medical College, Beijing, China. fuweijun@hotmail.com
Summary
Three-dimensional computed tomography angiography (3-D CTA) effectively diagnoses nutcracker phenomenon by visualizing left renal vein compression. This non-invasive imaging is also valuable for postoperative follow-up after surgical intervention.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Nephrology
Background:
- Nutcracker phenomenon, characterized by left renal vein (LRV) compression, can cause hematuria.
- Accurate diagnosis and monitoring are crucial for effective management.
Purpose of the Study:
- To evaluate the utility of 3-D computed tomography angiography (3-D CTA) in diagnosing nutcracker phenomenon.
- To assess the role of 3-D CTA in postoperative follow-up of patients with this condition.
Main Methods:
- 3-D CTA was employed to compare anatomical relationships of the LRV with the aorta and superior mesenteric artery (SMA) in patients and controls.
- Surgical transposition of the LRV was performed in four patients.
- 3-D CTA was used for pre- and postoperative assessments.
Main Results:
- 3-D CTA clearly depicted LRV compression between the aorta and SMA, with significantly smaller angles and distances in patients compared to controls (P < 0.05).
- Surgical transposition of the LRV was successful.
- Postoperative 3-D CTA indicated normalization of the aorto-SMA distance.
Conclusions:
- 3-D CTA is a valuable non-invasive tool for diagnosing nutcracker phenomenon by visualizing LRV compression.
- This imaging modality aids in assessing the success of surgical interventions and monitoring patients postoperatively.