DIAGNOSIS OF THE NUTCRACKER PHENOMENON USING 2-DIMENSIONAL ULTRASONOGRAPHY

Citation
M. Okada et al., DIAGNOSIS OF THE NUTCRACKER PHENOMENON USING 2-DIMENSIONAL ULTRASONOGRAPHY, Clinical nephrology, 49(1), 1998, pp. 35-40
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology
Journal title
ISSN journal
0301-0430
Volume
49
Issue
1
Year of publication
1998
Pages
35 - 40
Database
ISI
SICI code
0301-0430(1998)49:1<35:DOTNPU>2.0.ZU;2-L
Abstract
We aimed to establish new criteria for the diagnosis of the nutcracker phenomenon (N phenomenon) using ultrasonography (US). The left renal vein (LRV) was examined with US in 125 children, divided into three gr oups, namely the macroscopic hematuria group (23 children), the micros copic hematuria group (52 children) and the control group (50 normal c hildren) all without nephritis, urolithiasis and tumor. The following parameters were calculated: (1) the ratio of the diameter of the dilat ed part of the LRV (D) to that of the narrowed part of the same vein ( N) (D/N ratio), (2) the ratio of D to the aortic diameter (A) (D/A rat io) and (3) the difference in diameter between the LRV and the right r enal vein (RRV) (RVD difference). The D/A ratio and the RVD difference correlated significantly with the D/N ratio. This indicates that not only the D/N ratio but also the D/A ratio and RVD difference can be us ed for diagnosing the N phenomenon. The cutoff levels for the three pa rameters were set at the mean + 2 SD of the values of the normal contr ols, that is, at 3.7 (D/N ratio), 0.75 (D/A ratio) and 1.7 mm (RVD dif ference). We made diagnoses of the N phenomenon when two or more param eters were over the cutoff level. According to these criteria, most pa tients with macrohematuria and one third of patients with microhematur ia were positive for the N phenomenon. The D/A ratio and RVD differenc e were useful for diagnosing the N phenomenon, and as a result our cri teria can reduce misdiagnosis for normal children.