Abstract:
OBJECTIVE:Nutcracker Syndrome (NCS) is the extrinsic compression of the left renal vein by neighboring arterial, ligamentous, muscular, or osseous structures. Diagnosis is made by Doppler ultrasonography (US), multidetector computerized tomography (MDCT), magnetic resonance imaging (MRI), phlebography. The aim of the current study is to assess the value of MRI and compare the efficiency of different sequences in diagnosis and follow up of children with NCS. MATERIAL AND METHODS:A total of 40 children (female/male ratio 3:1) with NCS were included in this prospective study. A standardized abdominal MRI protocol was used and T2-TRUFI (True Fast Imaging with Steady-State Free Precession), T2-HASTE (Half Fourier Acquisition with Single Shot Turbo Spin Echo), T1-VIBE (Volumetric Interpolated Breath Hold Examination), and out-of-phase (opposed-phase) T1 sequences were obtained. The sequences were compared according to anatomical depiction, measurability, and pulsation artifact. RESULTS:A four point-scale was used to assess subjective image quality and the results were listed as: 1 = poor, 2 = fair, 3 = good, and 4 = excellent. Both in total and for each individual criterion, the highest scores were obtained with T2-TRUFI (total mean 3.74 ± 0.45, anatomical depiction 3.9 ± 0.3, measurability 3.8 ± 0.4, aortic pulsation artifact 3.52 ± 0.55). CONCLUSION:Although Doppler US is the gold standard technique in the diagnosis of NCS, MR imaging may be used as an additional modality, as it is superior to Doppler US in terms of anatomic depiction and a lower rate of imaging artifacts. Non-contrast MR imaging, particularly TRUFI sequence, may have an incremental value in the accurate diagnosis and follow-up of these patients.
journal_name
Clin Imagingjournal_title
Clinical imagingauthors
Er A,Uzunlulu N,Guzelbey T,Yavuz S,Kiyak A,Kayhan Adoi
10.1016/j.clinimag.2019.02.003subject
Has Abstractpub_date
2019-01-01 00:00:00pages
144-147eissn
0899-7071issn
1873-4499pii
S0899-7071(19)30036-1journal_volume
55pub_type
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