Morphological features and clinical feasibility of thoracic duct: Detection with nonenhanced magnetic resonance imaging at 3.0 T

Abstract

Purpose: To evaluate the detection of the thoracic duct using nonenhanced magnetic resonance imaging (MRI) and to determine the influence of some related disorders on the lymphatic duct. Materials and Methods:Highly fluid-sensitive sequence and fat-suppressed T2-weighted imaging (FS-T2WI) were performed in a total of 139 cases. The axial and coronal images were used to locate the thoracic duct and the measurement and evaluation of its dimensions were performed using a 3D maximum intensity projection (MIP) reconstruction image. The differences in the dimensions among control, portal hypertension, and common bile duct obstruction groups were compared using one-way analysis of variance. Results:The cisterna chyli was shown in 91% of cases on FS-T2WI, while the thoracic duct appeared in 70% of the MIP images. The common configuration of the cisterna chyli was tubular or saccular in 73%. Eighty thoracic ducts had a slight turn declining to the left at the level of T8-10. There was a significant difference in the transverse diameter of the thoracic duct between the portal hypertension group and other groups (F ¼ 5.638, P ¼ 0.005).Conclusion: Nonenhanced MRI is feasible for locating and depicting the morphological features of the thoracic duct. Portal hypertension may influence the dimension of the thoracic duct. THE THORACIC DUCT is the largest lymphatic duct, receiving about 3/4 of the lymph in the entire body and draining it into the left brachiocephalic vein. The alteration of lymphatic drainage caused by tumor, liver cirrhosis, or other diseases may result in morphological changes in the thoracic duct (1-3). Thus, visualization of the thoracic duct is essential for elucidation of the influence of related diseases on the lymphatic duct and for avoidance of injury during thoracic surgery. However, the thoracic duct is not easy to observe due to its small size and particular position (4,5). Some imaging modalities presently available to depict the thoracic duct include scintigraphy, radiographic lymphography, endoscopic ultrasound, and computed tomography (CT) (6-8); however, these have a number of drawbacks such as contrast material discomfort, long examination time, radiation exposure, and low detectability rate (5). Recently, visualization of the thoracic duct and cisterna chyli was reported using magnetic resonance imaging (MRI) with a highly fluid-sensitive sequence such as the half-Fourier fast spin echo (FSE) technique (5,9). We also found incidentally that the entire thoracic duct could be shown on postprocessed images of thin-collimation 3D MR cholangiopancreatography (MRCP). In addition, the segments of the thoracic duct and cisterna chyli were also identified on contiguous images with fat-suppressed T2-weighted imaging (FS-T2WI).Our present aim was to evaluate the effectiveness of detection and the detailed position, configuration, and dimension of the thoracic duct, as well as the dimensional changes caused by some disorders, using FS-T2WI and a highly fluid-sensitive sequence. MATERIALS AND METHODS Pat...

Morphology of the distal thoracic duct and the right lymphatic duct in different head and neck pathologies: an imaging based study

“…The mean diameter of the TD varies between the reports in literature. While the mean diameter of healthy individuals in our study (4.54 mm) correlates quite well with the CT-based results of Liu et al (4.8 mm [ 1 ]), lower mean diameters from 1.9 to 3.74 mm were reported for MRI [ 7 , 9 ] and ultrasound [ 5 , 17 ] (Table 1 ). This could be explained in some part by the different image resolution in different modalities and the possible influence of inspiration and expiration on the TD’s calibre [ 7 ].…”

“…While there are various reports in the literature about the influence of pathologies of the body trunk (e.g. malignancies, portal venous hypertension, congestive heart failure) on the imaging morphology and function of the main lymphatic vessels [ 2 – 9 ] to the best of our knowledge there exist no data regarding diseases of the head and neck. Therefore the aim of this study was to assess the influence of head and neck pathologies on the morphology of the distal thoracic duct and right lymphatic duct in CT.…”

Proteolysis and Oxidation of Therapeutic Proteins After Intradermal or Subcutaneous Administration

“…109,110 The thoracic duct diameter was 3.6 ± 0.1 mm in healthy humans. 111 In another report, the diameter was reported as a range of 2 to 5 mm. The length of the thoracic lymph duct is around 45 cm.…”

“…The diameter increased (4.8 ± 0.4 mm) in the case of patients with portal hypertension. 111 Physical activity or exercise, heat, massage, and increase in hydrostatic pressure in the lymph vessels may result in elevated lymph flow. By contrast, cold, lack of movement, and external pressure may lead to reduced lymph flow.…”

MRI of the Central Lymphatic System

“…Recent advances in magnetic resonance (MR) software and hardware have allowed for improved visualization of the of lymphatic system on MR and increasing options for less invasive management of disorders of the lymphatic system. 1 In contrast to computed tomography and ultrasonography, which are used primarily to evaluate lymph nodes, MRI can be used to assess lymph nodes, the central and peripheral lymphatics. Imaging of the lymphatic system by MRI, previously referred to in the literature as MR lymphangiography (MRL), can be performed for diagnostic purposes or for pre-procedural planning.…”