Multidetector computed tomography findings and correlations with proteinuria in nutcracker syndrome.
We evaluated the effectiveness of multidetector computed tomography (MDCT) as a diagnostic tool for nutcracker syndrome (NS) and its association with proteinuria. The angle and distance between the aorta and the superior mesenteric artery (SMA), the degree of difference in corticomedullary enhancement (DCE) between kidneys in the nephrographic phase of computed tomography, peak velocity ratio (PVR), and anteroposterior diameter ratio (APDR) in the sonogram were measured. The MDCT results, sonogram results, and the ratio of protein:creatinine were significantly different between NS patients and the controls. The area under the curve for angle, distance, and DCE were 0.895 +/- 0.058, 0.876 +/- 0.063, and 0.942 +/- 0.036, respectively. The cutoff values for angle and distance had sensitivity and specificity values of 96.2 and 80% for <22.4 degrees and 84.6 and 80% for <4.9 mm, respectively. The DCE had a sensitivity of 88.5% and a specificity of 100% for the positive scores. There were significant correlations between the degree of DCE and the ratio of protein:creatinine (r = 0.337, p = 0.031), and between distance and the ratio of protein:creatinine (r = -0.419, p = 0.006). We conclude that MDCT has diagnostic value for NS in children and that MDCT findings are correlated with proteinuria.
Cho
Byoung Soo
BS
Department of Pediatrics, School of Medicine, Kyung-Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea.
Suh
Jin Soon
JS
Hahn
Won Ho
WH
Kim
Sung Do
SD
Lim
Joo Won
JW
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D010146:Pain / Q000209:etiology / Q000473:pathology; D011507:Proteinuria / Q000209:etiology / Q000473:pathology*; D012079:Renal Circulation / Q000502:physiology; D012082:Renal Veins / Q000000981:diagnostic imaging*; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018608:Ultrasonography, Doppler