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

Abstract

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.

Anatomic and volumetric characterization of the cisterna chyli using CT lymphangiography and computer‐assisted design software in dogs with idiopathic chylothorax

“…The location of the CC was consistent with previous reports, 15–17 as it was located in most cases between L1 and L4, with the caudal border typically being the convergence of lumbar trunks and near the level of the left renal hilus. The cranial extent of the CC was more variable, reaching as far as T11 and ranging from the gradual tapering of a single TD to the rapid trifurcation of three distinct TD branches.…”

“…Despite its significance, the anatomy of the CC can be challenging to assess in the clinical setting 14 . Previous studies have investigated and characterized the anatomy of the CC in dogs using contrast enhanced CT, MRI, and abdominal ultrasonography 15–17 . Computed tomography lymphangiography (CTLa) is currently considered the gold standard for evaluating the lymphatic system in dogs with chylothorax 18–21 ; however, based on our review of the literature, there are no reports evaluating the use of CTLa to characterize the CC in dogs with naturally occurring lymphatic disease such as idiopathic chylothorax.…”

A radio‐anatomical correlation study of the cisterna chyli

“…; Wachsberg, ; Etienne et al. ). 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.…”

“…Furthermore, the appearance of the CC can mimic an enlarged retrocrural lymph node on abdominal CT and correct identification is quite difficult (Gollub & Castellino, 1996;Pinto et al 2004;Feuerlein et al 2009), unless it is specifically studied on thin-slice, multiplanar reconstructions (Kiyonaga et al 2012). 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).…”

Morphology of the cisterna chyli in nine dogs with idiopathic chylothorax and in six healthy dogs assessed by computed tomographic lymphangiography

“…The cisterna chyli has been described as a 5-to 9-mm diameter crescent-like to globular structure located dorsolateral to the aorta. 6,7 However, when dogs with idiopathic chylothorax have been examined, anatomical variation has been noted. 8 Cisterna chyli ablation is performed to create a large opening in this reservoir, allowing chyle to be redirected from the thoracic duct back into the abdomen.…”