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. 2007 May;166(5):399-404.
doi: 10.1007/s00431-006-0252-7. Epub 2006 Oct 19.

Effect of renal Doppler ultrasound on the detection of nutcracker syndrome in children with hematuria

Jae Il Shin  1 , Jee Min Park, Jae Seung Lee, Myung Joon Kim
Affiliations

Effect of renal Doppler ultrasound on the detection of nutcracker syndrome in children with hematuria

Jae Il Shin et al. Eur J Pediatr. 2007 May.

Abstract

To assess the detection rate of nutcracker syndrome in children with isolated hematuria, renal Doppler ultrasound examinations were routinely performed on 216 consecutive children (176 microscopic hematuria and 40 gross hematuria). Renal Doppler ultrasound was also performed on 32 healthy normal children. The peak velocity (PV) was measured at the hilar portion of the left renal vein (LRV) and at the LRV between the aorta and the superior mesenteric artery. The PV at the aortomesenteric portion (P=0.003) and the PV ratios of the LRV (P=0.003) were significantly higher in children with hematuria than in normal children, while the PV at the hilar portion was not different. If a PV ratio of the LRV of at least 4.1 (the cut-off level set at the mean +/-2 SD of the value for the normal children) was defined as abnormal, 72 cases (33.3%) in children with hematuria and no cases in normal children were diagnosed as having nutcracker syndrome. The prevalence of nutcracker syndrome is relatively high in children with isolated hematuria, and the inclusion of renal Doppler ultrasound as a screening examination has a substantial effect on the detection of nutcracker syndrome.

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Figures

Fig. 1
Fig. 1
Renal Doppler ultrasound of the left renal vein in a patient with nutcracker syndrome (a, b) and a normal child (c, d). (a) The peak velocity was 194.8 cm/s in the aortomesenteric entrapped portion. (b) The peak velocity was 21.3 cm/s in the hilar portion (c). The peak velocity was 49.3 cm/s in the aortomesenteric portion. (d) The peak velocity was 23.8 cm/s in the hilar portion
Fig. 2
Fig. 2
The peak velocity ratios of the left renal vein in children with gross (GH) or microscopic hematuria (MH) and normal controls
See this image and copyright information in PMC

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