CT淋巴管成像在诊断原发性乳糜胸中的价值  

The Value of CT Lymphangiography in the Diagnosis of Primary Chylothorax

作　　者：张晓杰 郝琪 刘梦珂 孙小丽[1] 王仁贵[1] ZHANG Xiaojie;HAO Qi;LIU Mengke(Department of Radiology,Beijing Shijitan Hospital,Capital Medical University,Beijing,100038,P.R.China)

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]北京大学人民医院放射科,100044

出　　处：《临床放射学杂志》2024年第8期1348-1351,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:61876216)。

摘　　要：目的探讨CT淋巴管成像(CTL)在诊断原发性乳糜性胸腔积液中的价值。方法回顾性分析65例经临床确诊为原发性乳糜性胸腔积液患者的临床及影像学资料,所有患者均行直接淋巴管造影(DLG)和CTL检查,分析其对比剂异常沉积和返流及淋巴管形态异常。结果65例患者CTL后碘油异常沉积的部位:左侧胸腔6例,右侧胸腔2例,双侧胸腔6例,左侧胸膜下6例,右侧胸膜下5例,双侧胸膜下4例,左侧胸壁3例,右侧胸壁1例,双后胸壁1例,肺门7例,肺脏10例,心包周围4例,支气管血管束周围3例,左支气管纵隔干1例,双支气管纵隔干1例,左颈干1例,左颈静脉角区22例,双颈静脉角3例,双侧锁骨下干1例,左腋窝3例,双腋窝3例,纵隔37例,胸导管主干13例,右淋巴导管2例。结论CTL中对比剂在肺脏、淋巴导管和淋巴干的异常分布是原发性乳糜性胸腔积液的重要表现,提示胸部脏器、淋巴导管和淋巴干的异常分布和严重程度,为诊治原发性乳糜性胸腔积液提供更多的影像依据。Objective To explore the value of CT lymphangiography(CTL)in the diagnosis of primary chylothorax.Methods The clinical and imaging data of 65 patients diagnosed with primary chylothorax were retrospectively analyzed,and all patients underwent direct lymphangiography(DLG)and CTL to analyze the abnormal deposition and reflux of the contrast agent and the morphological abnormalities of the lymphatic vessels.Results The sites of abnormal iodine oil deposition after CT lymphangiography in 65 patients were as follows:left thoracic cavity in 6 cases,right thoracic cavity in 2 cases,bilateral thoracic cavity in 6 cases,left subpleural cavity in 6 cases,right subpleural cavity in 5 cases,bilateral subpleural cavity in 4 cases,left thoracic wall in 3 cases,right thoracic wall in 1 case,bilateral posterior thoracic wall in 1 case,pulmonary hilum in 7 cases,lung in 10 cases,peripericardium in 4 cases,peribronchiovascular bundles in 3 cases,left bronchiolo⁃mediastinal trunk in 1 case,and 1 case of double bronchial mediastinal trunk,1 case of left jugular trunk,22 cases of left jugular venous angle area,3 cases of double jugular venous angle,1 case of bilateral subclavian trunk,3 cases of left axilla,3 cases of double axilla,37 cases of mediastinum,13 cases of main thoracic duct and 2 cases of right lymphatic duct.Conclusion Abnormal distribution of contrast agent in CTL in the lungs,lymphatic conduits and lymphatic trunks is an important manifestation of primary chylothorax,suggesting the abnormal distribution and severity of the thoracic organs,lymphatic conduits and lymphatic trunks,and providing more imaging basis for the diagnosis and treatment of primary chylothorax.

关 键 词：原发性乳糜性胸腔积液 X线计算机 体层摄影术 淋巴管造影 

分 类 号：R561.7[医药卫生—呼吸系统]