Korean J Radiol.  2019 Dec;20(12):1627-1637. 10.3348/kjr.2019.0084.

Doppler US and CT Diagnosis of Nutcracker Syndrome

Affiliations
  • 1Department of Radiology, Seoul National University Hospital, Seoul, Korea. kimshrad@snu.ac.kr
  • 2Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.

Keyword

Nutcracker syndrome; Left renal vein; Renal vein hypertension; Doppler US; Contrast-enhanced CT

MeSH Terms

Aorta, Abdominal
Diagnosis*
Hematuria
Hypertension
Mesenteric Artery, Superior
Renal Veins
Tomography, X-Ray Computed
Ultrasonography, Doppler
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