Clinical value of ultrasonography in the diagnosis of left renal vein behind abdominal aorta / 中国医师杂志

ABSTRACT

Objective:The purpose of our study was to assess the clinical value of ultrasound in the diagnosis of retroaortic left renal vein (RLRV) behind abdominal aorta.Methods:The ultrasound images of patients with RLRV diagnosed by ultrasound in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2013 to 2018 were retrospectively analyzed. The general information, clinical symptoms, ultrasound images and other clinical data of the patients were collected and analyzed.Results:RLRV was detected in 16(0.46%) cases of the 3 519 patients from 2013 to 2018 using ultrasonography, and the male to female ratio was 11 to 5. All patients presented with hematuria, including 7 patients with other symptoms, such as left flank pain. Ultrasound were firstly performed in all patients. Of the 16 patients, 15(93.75%) cases were of complete retroaortic type Ⅰ, including 13(81.25%) cases with left renal vein compression and 2(12.5%) cases with complete retroaortic type without left renal vein compression. In 16 cases, 1 case (6.25%) was type Ⅲ, with compression of both branches.Conclusions:Ultrasound may be the preferred method for the left renal vein examination when a clinical suspicion of Nutcracker syndrome is required. Ultrasound can clearly show the left renal vein in most patients, to determine whether the left renal vein is mutated or compressed. Ultrasound has the highest sensitivity for detecting the type Ⅰ, which is not easy to misdiagnose. However, type Ⅲ is easy to misdiagnosis. Whereas the type Ⅱ and type Ⅳ is difficult to detect using ultrasound, which may be related to the limitations of ultrasound imaging.