CT淋巴管造影对乳糜尿的诊断价值

目的 探讨CT淋巴管造影对直接淋巴管造影术后乳糜尿的诊断价值.方法 回顾性分析11例乳糜尿患者的核素淋巴显像、直接淋巴管造影、CT淋巴管造影并经手术证实的所有资料.结果 11例乳糜尿患者中,核素淋巴显像发现胸导管扩张8例,腰干增宽5例,肾盂显影7例；直接淋巴管造影发现胸导管扩张10例,腰干淋巴管纡曲、扩张11例,对侧腰干、腹膜后淋巴管反流4例,向肾盂反流10例；CT淋巴管造影发现胸导管扩张9例,右淋巴管扩张1例,腰干、腹膜后、髂、盆腔淋巴管纡曲、扩张11例,对侧腰干、腹膜后淋巴管反流10例,肾盂、肾窦反流11例.结论 CT淋巴管造影可以发现更多病变淋巴管,并清晰显示其周围解剖关系,对核素淋巴显像和直接淋巴管造影的低空间分辨力起到补充作用.

Diagnosis of chyluria with CT lymphangiography

Objective To explore the value of CT lymphangiography in patients with chyluria after direct lymphangiography (DLG). Methods Data of 11 patients with chyluria who underwent lymphoscintigraphy, DLG and CT lymphangiography were analyzed retrospectively. All the patients were confirmed by pathology after surgeries. Results Among 11 patients, lymphoscintigraphy detected ectasia of thoracic duct in 8 cases, lumbar trunk dilation in 5 and renal pelvis backflow in 7 cases. DLG detected ectasia of thoracic duct in 10 cases, lumbar trunk dilation in 11, contralateral lumbar trunk and retroperitoneal lymph vessels backflow in 4 and renal pelvis backflow in 10 cases. CT lymphangiography detected ectasia of thoracic duct in 9 cases, dilation of right lymph vessels in 1 case, lumbar trunk, retroperitoneal, iliac and pelvic lymph vessels dilation in 11 cases, backflow to contralateral lumbar trunk and retroperitoneal lymphatic vessel in 10 and renal pelvis and sinus renalis backflow in all cases. Conclusion CT lymphangiography can detect more abnormal lymph vessels than lymphoscintigraphy and DLG, demonstrate surrounding anatomical configuration, therefore complementing low spatial resolution of the latters.