Nutcracker syndrome in children with gross haematuria: Doppler sonographic evaluation of the left renal vein

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Cheon, Jung-Eun; Kim, Woo Sun; Kim, In-One; Kim, Seung Hyup; Yeon, Kyung Mo; Ha, Il Soo; Cheong, Hae Il; Choi, Yong
Issue Date
Springer Verlag
Pediatr Radiol 36(7):682-686
HaematuriaRenal veinsUltrasoundDopplerNutcracker syndromeBlood Flow VelocityConstriction, PathologicHematuria/physiopathology/*ultrasonographyPeripheral Vascular Diseases/physiopathology/*ultrasonographyRenal Veins/physiopathology/*ultrasonography
BACKGROUND: Nutcracker syndrome is characterized by gross haematuria caused by left renal vein (LRV) entrapment. OBJECTIVE: To assess the role of LRV ultrasonography in the diagnosis of the nutcracker syndrome in children. MATERIALS AND METHODS: Twelve children (eight male, four female; mean age 12.8 years) with venographically confirmed nutcracker syndrome (LRV-IVC pressure gradient > or = 3 mm Hg) underwent LRV sonography including Doppler spectral analysis (n=7). The diameter and peak velocity (PV) were measured at two sites of the LRV (renal hilum and aortomesenteric portion). The US findings of nutcracker syndrome were compared with those of 20 control subjects using the t-test. We identified the optimal cut-off value of the US parameters for the diagnosis of the nutcracker syndrome using ROC analysis. RESULTS: The PV at the aortomesenteric portion and the ratio of the PV between the two measured points showed significant differences between the two groups (P<0.0001). The optimum cut-off values were found to be 4.7 for the PV ratio (sensitivity 100%, specificity 90%, accuracy 93%), and 93 cm/s for the PV at the aortomesenteric portion (sensitivity 100%, specificity 85%, accuracy 89%). CONCLUSION: LRV sonography, including Doppler spectral analysis, can demonstrate LRV entrapment haemodynamically.
0301-0449 (Print)
1432-1998 (Electronic)
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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