特发性乳糜尿患者直接淋巴管造影后CT表现

目的 采用直接淋巴管造影CT(PLCT)观察特发性乳糜尿患者泌尿系统及其他腹部区域淋巴管表现.方法 观察26例乳糜尿患者PLCT图像,分析泌尿系统及腹部其他区域对比剂异常分布部位及范围,进行影像学分型;并根据临床表现进行分型,以K ap p a检验评估2种分型结果的一致性.结果 26例中,25例(25/26,96.15...

Post-direct lymphangiography CT findings in patients with idiopathic chyluria

Objective To observe performances of lymphatic vessels of urinary system and other regions of the abdomen in patients with idiopathic chyluria using direct post-lymphangiography CT (PLCT). Methods Direct PLCT images of 26 patients with chyluria were reviewed, the site and extent of abnormal distribution of contrast in urinary system and other abdominal regions were analyzed, and imaging classifying of idiopathic chyluria was performed. In addition, clinical classifying was performed according to the clinical presentation, and the concordance between the two classifying methods was assessed using Kappa test. Results Among 26 cases, abnormal contrast material distribution in the unilateral or bilateral renal regions were observed in 25 cases (25/26, 96.15%), while no contrast material distribution in bilateral renal region was detected in 1 case (1/26, 3.85%). Abnormal contrast material distribution in the ureter was noticed in 7 cases (7/26, 26.92%), at the entrance of ureter in 11 cases (11/26, 42.31%), while in the bladder in 14 cases (14/26, 53.85%). Dilated retroperitoneal and paravertebral lymphatic vessels and abnormal communication with the outer of renal capsule and the subcutaneous region were found in all 26 cases (26/26, 100%).Contralateral side parietal iliac vessels and abnormal inguinal contrast distribution were observed in 15 cases (15/26, 57.69%) and 10 cases (10/26, 38.46%), respectively. Punctate distribution of contrast material in the abdominopelvic lymph nodes was found in 4 cases (4/26, 15.38%). Abnormal distribution of contrast medium in left costal space and spleen were observed each in 1 case, respectively. The lymphatic branch of the left renal pedicle ran and communicated to the hilus of left kidney in 1 case. Among 26 cases, 12 were clinically classified mild and 14 were classified severe, while 14 were PLCT classified mild and 12 were classified severe, the consistency of the two classifying methods was general (Kappa=0.235, P<0.05). Conclusion PLCT could be used to observe the site, distribution and extent of abnormal lymphatic-urinary communication and dilated lymphatics in patients with idiopathic chyluria.