MR在女性生殖系统乳糜漏中的应用

目的 探讨磁共振胸导管成像(MRTD)及MR盆腔扫描在女性生殖系统乳糜漏中的应用价值.方法 收集7例影像资料完整并经手术证实的女性生殖系统乳糜漏患者资料,回顾性分析其MRTD及MR盆腔平扫的影像学表现,并与直接淋巴管造影(DLG)、核素淋巴显像及手术相对照.结果 DLG中胸导管显示率71.4%(5/7).核素淋巴显像静脉角区显影率为71.4%(5/7).MRTD胸导管显影100%(7/7),除1例未见明确异常外,余6例(85.7%)均提示胸导管出口梗阻,其中双侧引流1例,右位胸导管1例,4例伴静脉角周围多发迂曲淋巴管,1例伴左静脉角区多发淋巴管瘤.7例患者均行胸导管探查术,6例证实胸导管出口梗阻,1例未见明显异常.MRTD联合MR盆腔扫描对比DLG发现了更多淋巴管瘤,并发现了2例骨质异常.结论 MRTD结合MR盆腔扫描可对女性生殖系统乳糜漏患者作出更全面的评估,应该作为这类患者术前常规检查手段.

Magnetic resonance in chylous leakage of female reproductive system

Objective To evaluate the value of magnetic resonance thoracic ductography (MRTD)and magnetic resonance (MR) pelvic scanning in the chylous leakage of female reproductive system.Methods A retrospective evaluation of the imaging findings of MRTD and MR pelvic in 7 patients was performed,and compared with direct lymphangiography (DLG),lymphoscintigraphy and surgery.Results The rate of thoracic duct visualization in DLG was 71 .4% (5/7 ).The rate of venous angle visualization inlym-phoscintigraphy was 71.4% (5/7).The rate of thoracic duct visualization in MRTD was 100% (7/7).Except for 1 case withgeneral-ly normal findings,the remaining 6 cases showedobstruction of the thoracic duct in MRTD.Among those cases,bilateral drainage was found in 1 case,right thoracic ductwas seen in 1 case,multiple tortuous dilated lymphatic channelsaround the venous angle was detected in 4 cases,and multiple lymphangiomas was seen in 1 case.All of the 7 patients were conducted by surgery.6 cases were confirmed as obstruction of the thoracic duct.MRTD & MR pelvic found more multiple lymphangiomas lesions and detected 2 cases with bone abnormalities.Conclusion MRTD combined with MR pelvic could provide more comprehensive assessment of female re-productive system chylous leakage.It should be used as routine examination before operation.