The value of color Doppler ultrasound in the diagnosis of congenital anomalies of the inferior vena cava / 中华医学超声杂志（电子版）

ABSTRACT

Objective To analyze the congenital anomalies of inferior vena cava (IVC) with their color Doppler and clinical features, and to evaluate the value of color Doppler ultrasound in the diagnosis of congenital anomalies of the IVC. Methods Between July 2009 and March 2012, 22 patients who were diagnosed as IVC anomalies by color and spectral Doppler ultrasound were retrospectively analyzed. After careful and comprehensive scanning on multiple planes, the final diagnosis was made based on the findings obtained on B-mode, color Doppler and spectral Doppler ultrasound. All the results obtained by sonography were compared with computerized tomography angiography, digital subtraction angiography, and other clinical examinations. Results There were 22 cases diagnosed as congenital anomalies of IVC, including 5 cases of the left IVC, 3 cases of the double IVC, 3 cases of membranous obstruction of the IVC (MOVC) and 11 cases of the anomalies of the left renal vein. In left IVC, the infrarenal left-sided IVC entered into the left renal vein, then crossed anterior to the aorta to join the right-sided suprarenal IVC. In double IVC, bilateral IVCs could be seen on both sides of the abdominal aorta, and the left IVC joined the right IVC over aorta then entered into the right atrium. Some patients of the left IVC and double IVC had left renal vein hypertension. All the cases of MOVC in our study presented as Budd-Chiari syndrome, in which B-mode ultrasonography showed the existence of the membranous obstruction in inferior vena cava at the level of entrance to the right atrium. On color Doppler lfow image (CDFI), reverse blood lfow into lumbar and ascending lumbar vein was found. Eleven cases of left renal vein malformations were also seen in present study, including 9 cases of retroaortic left renal vein, 1 case of circumaortic left renal vein and 1 case of the left renal vein into the left common iliac vein. Among them, 9 cases were associated with left renal vein hypertension. Conclusion Color and spectral Doppler ultrasound can clearly identify the congenital anomalies of IVC with the evaluation of their hemodynamic modiifcation, and can be used as an important approach in the diagnosis of the anomalies of the IVC.