Computed Tomographic Lymphography of the Thoracic Duct by Mesenteric Lymph Node Injection
| Autor: | Andrew E. Kyles, Carl Koehler, Erik R. Wisner, Eric G. Johnson, Stanley L. Marks |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Contrast Media Chylothorax Thoracic duct Injections Thoracic Duct Dogs Iodinated contrast Preoperative Care medicine Animals Mesentery Dog Diseases Prospective Studies Lymph node Ultrasonography Interventional General Veterinary business.industry Lymph duct Lymphography Cisterna chyli medicine.disease Contrast medium medicine.anatomical_structure Lymphatic system Lymph Nodes Radiology Tomography X-Ray Computed business |
| Zdroj: | Veterinary Surgery. 38:361-367 |
| ISSN: | 1532-950X 0161-3499 |
| Popis: | Objective— To document a novel technique to image the thoracic duct and its tributaries by contrast enhanced computed tomography (CT) lymphography. Study Design— Clinical report. Animals— Dogs (n=6) idiopathic chylothorax. Methods— Ultrasonography was used to guide percutaneous injection of intestinal lymph nodes with nonionic iodinated contrast medium for preoperative CT lymphography of the thoracic duct in 6 dogs with chylothorax. Thoracic CT images were acquired immediately after contrast medium injection. All dogs had subtotal pericardectomy and thoracic duct ligation. Postoperative thoracic duct lymphography was performed in 3 dogs. Superficial cervical lymph node lymphography was performed in 2 dogs to determine cervical lymphatic contribution to thoracic effusions. Results— Preoperative thoracic duct lymphography using this technique was successful in delineating the cisterna chyli, thoracic duct, and associated lymphatic vessels in all dogs. Immediate postoperative lymphography performed in 2 dogs revealed successful duct ligation in 1 dog and persistent lymphatic leakage in the other. A 1-month postoperative thoracic duct lymphogram performed in 1 dog revealed unsuccessful ligation or recannulation of 1 of 3 redundant vessels seen preoperatively. Conclusion— Percutaneous CT lymphography results in excellent detection of the thoracic duct and abnormal thoracic duct drainage patterns both pre- and postoperatively. The contribution of superficial cervical lymph node drainage to reoccurrence of effusions can be evaluated. Clinical Relevance— Percutaneous CT lymphography using ultrasound-guided contrast medium injection should be considered as an alternative to conventional open abdominal approaches to radiographic or CT lymphography. |
| Databáze: | OpenAIRE |
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