CT淋巴管成像用于特发性乳糜尿分型北大核心CSCD

目的基于CT淋巴管成像(CTL)对特发性乳糜尿进行分型,观察其临床与影像学表现差异。方法回顾性分析37例特发性乳糜尿患者的CTL图像,评价有无淋巴反流、淋巴瘘及颈部/腋下异常对比剂分布;根据对比剂异常分布范围将其分为单纯型(仅泌尿系统受累)与复杂型(伴其他部位受累),比较不同分型乳糜尿患者临床及影像学表现的差异。结果37例特发性乳糜尿中,单纯型27例、复杂型10例。相比单纯型,复杂型发病年龄小、病程短,淋巴反流占比高(P均<0.05);而患者性别比例、临床分级、肾脏受累范围及程度、淋巴瘘及颈部/腋下异常对比剂分布差异均无统计学意义(P均>0.05)。结论复杂型特发性乳糜尿较单纯型发病年龄小、病程短,淋巴反流占比高。CTL可观察异常淋巴管所在部位、分布和范围,有助于探讨发病机制及选择治疗方式。

CT lymphangiography for classification of idiopathic chyluria

Objective To classify idiopathic chyluria based on CT lymphangiography (CTL), and to observe clinical and imaging characteristics of different types of chyluria. Methods CTL images of 37 patients with idiopathic chyluria were reviewed, and the lymph reflux, lymph leakage and abnormal distribution of contrast media around neck/armpit area were juged. Based on the range of abnormal distribution of contrast media, the lesions were classified into simple type (only involved urinary system) and complicated type (involved urinary and other systems), and the clinical and imaging features were compared. Results Compared with simple type idiopathic chyluria, complicated type idiopathic chyluria had smaller onset age, shorter course of disease and higher rate of lymph reflux (all P<0.05). There was no significant difference of the sexual ratio, clinical stage, range and extent of kidney lesions, leakage nor abnormal distribution of contrast media around neck/armpit area between different types (all P>0.05). Conclusion Complicated type idiopathic chyluria demonstrated smaller onset age, shorter course of disease, and higher rate of lymph reflux compared with simple type. CTL could detect the location, distribution and range of abnormal lymphatics of chyluria and classify the types of chyluria based on imaging features, hence being helpful for mechanical investigation and therapeutic adoptions.