Lymphangiography: A Case Study

Syed, Labib; Georgiades, Christos; Hart, Vicki L.

doi:10.1055/s-2007-971180

Cited by 16 publications

(9 citation statements)

References 11 publications

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“…An unusually dilated cisterna chyli may potentially be misidentified as a retrocrural lymph node or a vascular structure in abdominal ultrasonography studies. Ultrasound has been described as a method for guiding percutaneous embolization of the thoracic duct via the cisterna chyli in patients with chyloabdomen or chylothorax . The size of the cisterna chyli based on ultrasonography has been described in humans as a method for diagnosing increased lymphatic flow (e.g., portal hypertension) or lymph flow obstruction (e.g., congestive heart failure or malignant obstruction) .…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Characteristics of the Cisterna Chyli in Eight Dogs and Four Cats

Etienne

Cavrenne

Gommeren

et al. 2013

Vet Radiology Ultrasound

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Ultrasonography of the cisterna chyli has been used in humans to diagnose increased lymphatic flow or lymph flow obstruction and to guide percutaneous embolization of the thoracic duct via the cisterna chyli. The aim of this study was to describe the ultrasonographic characteristics of the dorsal portion of cisterna chyli in dogs and cats with chylous ascites or chylothorax and in a group of healthy dogs and cats. The aorta and the cranial mesenteric artery were used as anatomic landmarks. Ultrasonography was performed before and 2 h after a fatty meal in healthy dogs and cats. The visualized structure was confirmed to be a dilated cisterna chyli at necropsy in a dog with chylous ascites. The confirmed or presumed cisterna chyli was consistently detected using ultrasonography in nonfasted healthy animals and clinically affected animals and appeared as an anechoic tubular structure, without detectable flow, at the right dorsolateral aspect of the aorta. It had a similar ultrasonographic appearance in patients with chyloabdomen and in nonfasted healthy dogs and cats. There was considerable overlap in diameters of the cisterna chyli for affected and healthy animals. The shape and size of the cisterna chyli in an individual animal were variable during the same ultrasound examination and between different examinations. This study demonstrated the appearance of the presumed dorsal portion of the cisterna chyli by ultrasonography and might provide useful preliminary data for further studies into the feasibility of ultrasound-guided injections or aspirations of the cisterna chyli in dogs and cats.

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Section: Introductionmentioning

confidence: 99%

Ultrasonographic Characteristics of the Cisterna Chyli in Eight Dogs and Four Cats

Etienne

Cavrenne

Gommeren

et al. 2013

Vet Radiology Ultrasound

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“…The CC is also difficult to differentiate from vascular structures or retrocrural lymph nodes on abdominal ultrasound (Tamsel et al 2006;Wachsberg, 2006;Etienne et al 2013). In patients with chyloabdomen or chylothorax, ultrasound has been described as a method to guide percutaneous embolization of the thoracic duct via the CC once it is opacified during lymphangiography (Hoffer et al 2001;Syed et al 2007;Lee et al 2014). Standard abdominal MRI, generally including highly fluid-sensitive T2-weighted sequences, only identifies the CC in 15% of patients (Pinto et al 2004).…”

Section: Discussionmentioning

confidence: 99%

A radio‐anatomical correlation study of the cisterna chyli

et al. 2018

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Surgical laparoscopic procedures in the retroperitoneal and supramesocolic spaces are increasingly frequent. There is a high risk of iatrogenic intraoperative injury of the retroperitoneal lymphatic structures during these procedures. A precise understanding of the anatomy of the thoracic duct (TD) and the cisterna chyli (CC) is essential for safe surgical procedures in this area. However, routine imaging procedures rarely and often incorrectly visualize the CC. The objective of this study was to evaluate the feasibility of a retrograde injection of the TD to fill the CC with a contrast agent in 16 human cadavers. Both magnetic resonance lymphography (MRI) and computed tomography (CT) studies could be performed on the same anatomical specimen, using a contrast medium which hardened, allowing gross dissection. MRI and CT detectability were evaluated, and imaging results were compared with the anatomical dissection. The CC of 12/16 cadavers were successfully injected, and four were unsuccessful due to technical difficulties, showing the effectiveness of the method. This technique can improve understanding of the anatomy of the TD and CC and provides an original option to study the complex anatomy of these structures by correlating precise cadaveric dissections with cross-sectional imaging.

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“…The overall morbidity and mortality related to lymphangiography has been reported to be lower than 5%. 34 The most notable complication is pulmonary oil embolism which was found to be directly related to the volume of Lipiodol injected. A threshold limit of 10 mL per extremity or 1 mL/10 kg/extremity for a maximum dose of 7 mL/ extremity has been suggested in the literature.…”

Section: Outcomes and Complicationsmentioning

confidence: 99%