Objectives: The aim of this study was to evaluate the normal anatomy of the thoracic duct and cisterna chyli obtained by axial and multiplanar reformation (MPR) images of 1 mm slice thickness using multidetector row CT (MDCT). Methods: We evaluated the ability of MDCT to examine the normal anatomy of the thoracic duct and cisterna chyli. The axial and coronal images of thoracoabdominal MDCT images obtained in 50 patients (20 females and 30 males; mean age, 63.5 years; range, 32-81 years) were reviewed between January and October 2005. We excluded patients with malignant neoplasms, inflammation or vascular diseases (e.g. aortic aneurysm, aortic dissection) and those with a history of thoracoabdominal surgery. The thoracic duct was divided into three anatomical sections: the upper, middle and lower. We evaluated the degree of visualisation and the maximum size of the thoracic duct. We also evaluated the degree of visualisation, maximum size, configuration and location of the cisterna chyli. Results: Visualisation of the thoracic duct and cisterna chyli was almost 100% on axial and coronal images. The lower section of the thoracic duct was most clearly visualised among the three sections. There was little difference in the maximum size of the thoracic duct among the three sections. The cisterna chyli was most frequently located at the Th12 or L1 level, and the most common type was the ''straight thin tube type''. Conclusion: Axial and MPR images of 1 mm slice thickness using MDCT can clearly depict the thoracic duct and cisterna chyli.
Peripancreatic lymphatic networks are frequently involved in pancreatobiliary carcinoma, affecting the prognosis. However, little attention has been paid to CT imaging of normal and pathological conditions of peripancreatic lymphatic networks. We evaluated multi-detector row CT (MDCT) images of peripancreatic lymphatic networks invaded by pancreatic carcinoma and compared them with those of normal peripancreatic lymphatic networks using imaging reconstruction every 1 mm with a multiplanar reformation technique. Apart from the region around the pancreatic body and tail, normal peripancreatic lymphatic networks were detected as "linear structures" on MDCT. However, peripancreatic lymphatic invasion by pancreatic carcinoma was frequently identified as "reticular," "tubular," or "soft tissue mass" appearances in the peripancreatic fat tissues. Peripancreatic lymphatic invasion by pancreatic carcinoma was more frequently detected around the common hepatic artery, celiac artery, superior mesenteric artery, and left para-aortic area. Depending on the tumor location, positive peripancreatic lymphatic invasion was most frequent at the area around the common hepatic artery in the head region and at the area around the celiac artery in the body and tail regions. Knowledge of CT imaging of normal and pathological peripancreatic lymphatic networks is essential for determining the accurate staging of pancreatic carcinoma.
The lymphatic systems located around the pancreatic head and extrahepatic bile duct could be sufficiently visualized on SPIR T2-weighted images with 3D-VISTA at 3.0-T.
Salivary duct carcinoma (SDC) of the extra-glandular segment of Stensen's duct is a very rare but aggressive neoplasm. Ultrasonography, computed tomography, and magnetic resonance imaging findings in a patient pathologically proven to have SDC of the extra-glandular segment of Stensen's duct are reported. When an early peak enhancement region in the mass with a well-enhanced dilated and thickened Stensen's duct wall is apparent on dynamic studies, a SDC of the extra-glandular segment of Stensen's duct should be strongly suspected.
Peripancreatic strands appearance on MDCT in pancreatic body and tail carcinoma reflects extrapancreatic carcinoma invasion with marked fibrotic thickening of adipose tissue septa. This CT finding would indicate the property of carcinoma aggressiveness.
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