MR在女性生殖系统乳糜漏中的应用  

Magnetic resonance in chylous leakage of female reproductive system

作　　者：霍萌[1] 岳云龙[2] 金延方[2] 文哲[3] 张超[2] 王振常[4] 

机构地区：[1]首都医科大学附属北京世纪坛医院放射科,北京100038 [2]首都医科大学附属北京世纪坛医院磁共振室,北京100038 [3]首都医科大学附属北京世纪坛医院核医学科,北京100038 [4]首都医科大学附属北京友谊医院放射科,北京100050

出　　处：《实用放射学杂志》2017年第3期331-334,360,共5页Journal of Practical Radiology

基　　金：北京市属医院科研培育计划（PX2017049）;科技北京百名领军人才培养工程（Z141107001514002）.

摘　　要：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.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.

关 键 词：乳糜漏 生殖系统 磁共振胸导管成像 直接淋巴管造影 核素淋巴显像 

分 类 号：R711[医药卫生—妇产科学] R445.2[医药卫生—临床医学]