The Clinical Application of One-Stop Examination with 640-Slice Volume CT for Nutcracker Syndrome

BACKGROUND To investigate the relationship between the level of left renal vein (LRV) compression and changes in the perfusion of the left kidney in patients with nutcracker syndrome (NCS) by one-stop whole-organ perfusion imaging of bilateral kidneys using 640-slice volume CT. METHODS Twelve patients, clinically diagnosed with NCS, were subjected to one-stop examination of kidneys. Angiography and whole-organ perfusion imaging of bilateral kidneys were conducted, and the compression segment of LRV was demonstrated and measured. Information including the results of whole-organ perfusion images of both kidneys in 12 patients was collected. Results of epigastrium dynamic volume scanning by 640-slice volume CT were collected for 12 patients as control group. Left and right renal cortexes were chosen as regions of interest (ROI), and their perfusion values were measured. RESULTS The perfusion values of the left and right renal cortexes in the control group were 323.8 ml · min(-1) · 100 ml(-1) and 322.9 ml · min(-1) · 100 ml(-1), respectively. The difference was not statistically significant (t = 1.388, P = 0.193). For NCS patients, the perfusion values of the left and right renal cortexes were 350.8 ml · min(-1) · 100 ml(-1) and 391.1 ml · min(-1) · 100 ml(-1), respectively. Significantly decreased value was observed in left renal cortex compared to that of the right renal cortex, with the mean decrease of 40.3 ml · min(-1) · 100 ml(-1), and the difference was statistically significant (t = -4.204, P = 0.001). CONCLUSION As a non-invasive functional imaging technique, whole-organ perfusion imaging of kidneys can be used to evaluate the organ and tissue perfusion status and to accurately reflect the hemodynamic changes of the left renal cortex in the patients with NCS. Whole organ perfusion imaging may also provide the basis for quantitative diagnosis and clinical interventions of NCS.