Comparison of Computed Tomographic and Radiographic Popliteal Lymphangiography in Normal Dogs

Singh, Ameet; Brisson, Brigitte A.; Nykamp, Stephanie; O’Sullivan, M. Lynne

doi:10.1111/j.1532-950x.2011.00860.x

Cited by 20 publications

(16 citation statements)

References 15 publications

(48 reference statements)

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“…Several lymphangiographic studies have investigated the use of CT to assess the thoracic duct and its tributaries in dogs . However, to the authors’ knowledge, no published studies have described the specific appearance of the cisterna chyli using CT.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomographic Characteristics of the Cisterna Chyli in Dogs

Birch

Barberet

Bradley

et al. 2013

Vet Radiology Ultrasound

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Previous lymphangiographic studies have investigated the use of computed tomography (CT) for characterizing the thoracic duct and its tributaries in dogs. However, there is limited published information on the appearance of the canine cisterna chyli using CT. The objective of this retrospective study was to describe the features of the canine cisterna chyli in pre- and post-contrast abdominal CT studies. The presence, location, shape, maximum width, size compared with the aortic diameter (Ao:cisterna chyli ratio) and mean attenuation of the cisterna chyli were recorded from archived abdominal CT scans of 30 dogs. Breed, age, sex and neutering status were also noted. A cisterna chyli was identified in 26 of the dogs (87%). In 22 cases a cisterna chyli could be reliably identified prior to intravenous contrast administration and in all 26 cases in postcontrast images. The cisterna chyli was most commonly located right dorsolateral to the abdominal aorta between L1 and L4. Shape varied on transverse images from crescent-like to globular and maximum diameters ranged from 5 to 9 mm. The Ao:cisterna chyli ratio varied between 0.29 and 0.71 (mean value-males: 0.32; females: 0.38). On pre-contrast images the mean Hounsfield units were 21.3HU (range: -3.8 to 64.25). Mild enhancement of the cisterna chyli post-contrast was observed in 24 dogs (80%). Findings supported the use of pre- and post-contrast abdominal CT as a non-invasive method for assessing qualitative and quantitative characteristics of the canine cisterna chyli.

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Section: Introductionmentioning

confidence: 99%

Computed Tomographic Characteristics of the Cisterna Chyli in Dogs

Birch

Barberet

Bradley

et al. 2013

Vet Radiology Ultrasound

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“…However, as Singh et al (2010) did not find a significant difference in the number of observed lymphatic branches after left or right intrapopliteal iohexol injection during a radiographic and CT scan study in the dog, we hypothesised that the injection side should not have any impact on the results.…”

Section: Discussionmentioning

confidence: 94%

Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Vnuk¹,

Kurilj²,

Matičić³

et al. 2014

Vet. Med. - Czech

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Radiographic contrast studies have been recommended to identify the thoracic duct (TD) and its branches before and after surgery for total occlusion. The macroscopic identification of the TD and its branches during surgery usually involves injection of methylene blue (MB). Radiographic contrast and methylene blue can be injected into different anatomical structures (lymph node, lymph vessel, s.c.). The purpose of this study was to compare two different techniques (radiographic and thoracoscopic) for visualisation of the TD after intrapopliteal lymph node injection in the pig. Six piglets from the same litter (two males and four females), two months of age were used. Iohexol at 245 mg/ml was injected into the left popliteal lymph node (LN) under general anaesthesia; hindlimb, abdominal, and thoracic radiographs were taken. A 0.25% methylene blue solution was injected into the right popliteal lymph node and the thoracic duct colouration was assessed thoracoscopically. The thoracic duct was visualised radiographically in one out of six pigs after iohexol injection and thoracoscopically in five out of six pigs after methylene blue injection. The difference was statistically significant (P = 0.040). Popliteal LN lymphangiography using iohexol at 245 mg/ml in piglets should not be the recommended method for TD visualisation. Intrapopliteal injection of a 0.25% solution of methylene blue is recommended as a method of TD visualisation prior to thoracic duct ligation.

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“…The image diagnostic tools used were computed tomography (CT), tomography lymphangiography and echocardiogram. The CT made it possible to identify the thoracic organs, as well as the thoracic duct and its ruptured spots, because this equipment gives a tridimensional image with good resolution, lowering the interference of adjacent tissues overlap [12,13].…”

Section: Discussionmentioning

confidence: 99%

Chylothorax Associated with Subcutaneous Cellulitis Caused by Chylous Fluid Leakage in a Dog

Vieira

Mota

Borin-Crivellenti

et al. 2019

Acta Scientiae. Vet.

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Background: Chylothorax is the accumulation of lymphatic fluid associated with molecules coming from digestion process (chyle) in the thorax. In this case report, we describe a canine patient with chylothorax that presented with an unusual clinical presentation: subcutaneous swelling due to chylous fluid leakage through the thoracic inlet.Case: A 4 year-old spayed female canine, Giant Schnauzer, presented to the Ontario Veterinary College Health Sciences Centre for evaluation and treatment of bilateral subcutaneous masses and edema on the ventral thorax. The patient was originally evaluated by the primary care veterinarian and aspiration and cytology of the masses resulted in a large volume of fluid with low cellularity, lightly basophilic. Due to the appearance of the fluid, triglyceride levels were performed and was 7.95 mmol/L while the peripheral level was 0.5 mmol/L (ref: 0.2-1.3 mmol/L). Based on the cytology and triglyceride levels, chylous fluid was suspected to be the cause of the swelling and edema. Over the following 10 months, the swelling progressed to bilateral tumors of approximately 15 cm in the lateral thorax and surrounding edematous tissues on the ventral thorax. The patient was referred for evaluation. On presentation the patient was normal aside from the described thoracic swellings and decreased lung sounds on auscultation. Thoracic ultrasound revealed bilateral pleural effusion. Thoracentesis resulted in approximately 1,200 mL of chylous fluid. Thoracic computed tomography (CT) and lymphangiography through popliteal injection revealed bilaterally in the soft tissues of the axillary regions, and extending along the right thoracic wall, a moderate amount of fluid dense material. The lymphangiogram revealed two sites of rupture of lymphatic vessels, in the caudal thorax (right sided), and in the cranial mediastinum/right thoracic inlet. Based on the findings, a video-assisted thoracic duct ligation and cisterna chyli ablation were performed. A PleuralPort was placed at the time of surgery for percutaneous drainage of residual fluid. Initially the subcutaneous swelling/masses were noted to have resolved and the patient was discharge 3 days postoperatively with minimal residual thoracic fluid at the time of discharge. Five days after discharge, the patient was returned because the owners complained of not being able to perform the thoracic drainage through the PleuralPort. Based on the physical exam and radiography, the suspicion of PleuralPort obstruction or kink was raised. Thoracocentesis drained 2.5 L of apparently chylous fluid. On the next day, the patient returned for replacement of the port. Eighteen days after the replacement of the port, the patient presented again due to concerns about an inability to drain the pleural port, and that the patient respiration was becoming more laborious, especially during the night. Due to the continued presence of chylous effusion, the owners were offered a repeat lymphangiogram to determine whether additional unligated branches could be contributing to the continued effusion. The owners elected humane euthanasia.Discussion: Canine chylothorax with leakage of chylous fluid to the thoracic subcutaneous space has not been described until now. The fluid retrieved from the patient subcutaneous swellings was a chylous fluid, originated from the thorax. We hypothesized that the leakage of chylous fluid occurred through the thoracic inlet, where there is the pleural cupula, a protuberance of the pulmonary pleura, not protected by the ribs, place that could rupture easily. Because similar case was not reported, we found it important to be shared, so the veterinary scientific community can be aware of uncommon clinical presentations in patients with chylothorax.

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Comparison of Computed Tomographic and Radiographic Popliteal Lymphangiography in Normal Dogs

Abstract: CT popliteal lymphangiography consistently identified a greater number of TD branches when compared with radiographic popliteal lymphangiography. Injection of either popliteal lymph node resulted in the same number of TD branches being observed.

Cited by 20 publications

References 15 publications

Computed Tomographic Characteristics of the Cisterna Chyli in Dogs

Computed Tomographic Characteristics of the Cisterna Chyli in Dogs

Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Chylothorax Associated with Subcutaneous Cellulitis Caused by Chylous Fluid Leakage in a Dog

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