The usefulness of fast-spin-echo T2-weighted MR imaging in Nutcracker syndrome: a case report.
Nutcracker syndrome occurs when the left renal vein (LRV) is compressed between the superior mesenteric artery and the aorta, and this syndrome is often characterized by venous hypertension and related pathologies. However, invasive studies such as phlebography and measuring the reno-caval pressure gradient should be performed to identify venous hypertension. Here we present a case of Nutcracker syndrome where the LRV and intra-renal varicosities appeared homogeneously hyperintense on magnetic resonance (MR) fast-spin-echo T2-weighted imaging, which suggested markedly stagnant intravenous blood flow and the presence of venous hypertension. The patient was diagnosed and treated without obtaining the reno-caval pressure gradient. The discomfort of the patient lessened after treatment. Furthermore, on follow-up evaluation, the LRV displayed a signal void, and this was suggestive of a restoration of the normal LRV flow and a decrease in LRV pressure.
Wong
Heong-Ieng
HI
Department of Radiology, Yuan's General Hospital, Kaohsiung, Taiwan.
Wong
Heong-Leng
HL
Chen
Matt Chiung-Yu
MC
Wu
Cgek-Siung
CS
Fu
Kuo-An
KA
Lin
Cheng-Hao
CH
Weng
Mei-Jui
MJ
Liang
Huei-Lung
HL
Pan
Huay-Ben
HB
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012082:Renal Veins / Q000473:pathology* / Q000601:surgery; D015607:Stents; D013577:Syndrome; D014652:Vascular Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
J Urol. 1991 Sep;146(3):685-8
1875472
AJR Am J Roentgenol. 1999 Jan;172(1):39-43
9888735
Radiology. 1997 Aug;204(2):562-5
9240553
AJR Am J Roentgenol. 1980 Aug;135(2):339-42
6773339
Radiology. 1996 Jan;198(1):93-7
8539413
J Belge Radiol. 1972 Sep-Oct;55(5):507-11
4660828
Radiology. 1986 Sep;160(3):663-7
3737903