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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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366

Z. Xu et al.

 

 

9\ Renal Vein

9.1\ Transverse Section Left

of the Anterior Median Line:

Longitudinal View of the Left

Renal Vein

a1

 

a2

SMA

 

Ao

Ao

 

 

 

LRV

S

 

 

S

LK

 

b2

Gb

AU

PH

IVC

SMA

LRV

LK

SpV

CA

LRV

Ao

Fig.9.31  (a1) Transverse section left of the anterior median line: longitudinal view of the left renal vein, (b1) Transverse section on the anterior median line: Longitudinal view of the left renal vein

9  Abdominal Vascular Scanning

367

 

 

9.1.1\ Scanning Method

The method is the same as that used to examine the renal artery. The renal vein lies anterior to the renal artery without an aberration. Exerting some pressure on the cephalic or caudal part of the probe may facilitate both grayscale and color Doppler flow imaging of the left renal vein.

9.1.2\ Section Structure

Transverse section of the Ao, IVC, SMA; longitudinal section of the left renal vein; the left renal artery may also be shown sometimes; this section is useful to show the connection of the left renal vein and IVC.

9.1.3\ Measurement Method and Normal Value

The segment of the left renal vein between the Ao and SMA is usually narrow, and the velocity increases because of the compression of the two

arteries. The segment of the left renal vein left of the Ao is usually more than 1 cm in adults, with a continuous single-phase spectrum.

9.1.4\ Clinical Application Value

In the case of thrombosis or a tumor embolus, there will be enlargement of the lumen filled with a hypoechoic mass and without a blood flow signal. Both thrombosis and a tumor embolus can extend into the IVC. In a partial embolism, there is a filling defect in the involved segment. If the diameter ratio of the segment left and anterior to the Ao is ≥3 in the supine position or ≥4 in the spine posterior extension position after 15–20 min with blood flow velocity increases in the segment anterior to the Ao and decreases in the segment left to the Ao, this can be diagnosed as the “nutcracker” phenomenon.