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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
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Discriminating renal nutcracker syndrome from asymptomatic nutcracker phenomenon using multidetector computed
Seong Jong Yun1,2, Jung Min Lee2, Deok Ho Nam3
1Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, PO Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Korea.
Abdominal Radiology (New York)
|May 26, 2016
Summary
Computed tomographic (CT) findings can differentiate nutcracker syndrome (NCS) from asymptomatic nutcracker phenomenon (NCP). The superior mesenteric artery-aortic angle and dilated collateral veins with reflux are key indicators for diagnosing NCS.
Area of Science:
- Radiology
- Vascular Imaging
- Medical Diagnostics
Background:
- Nutcracker syndrome (NCS) involves left renal vein compression, often mistaken for asymptomatic nutcracker phenomenon (NCP).
- Accurate differentiation is crucial for appropriate patient management and treatment.
Purpose of the Study:
- To evaluate computed tomographic (CT) findings for distinguishing NCS from NCP.
- To determine the diagnostic value of CT in identifying NCS.
Main Methods:
- Retrospective analysis of 216 patients undergoing urographic CT.
- CT criteria included beak sign and left renal vein diameter ratio.
- Multivariate analysis identified factors differentiating NCS from NCP.
Main Results:
- Superior mesenteric artery-aortic angle and dilated collateral veins with reflux were independent predictors of NCS.
- A combination of SMA-aortic angle <25° and refluxing collateral veins achieved high diagnostic accuracy (AUC 0.841).
Conclusions:
- Multidetector CT findings, specifically SMA-aortic angle and collateral vein reflux, effectively differentiate NCS from NCP.
- These CT indicators aid in the diagnosis of nutcracker syndrome.
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