Lee K C, Cassar-Pullicino V N
Department of Radiology, Robert Jones & Agnes Hunt Orthopaedic & District Hospital, Oswestry, Shropshire, SY10 7AG, UK.
Clin Radiol. 2000 Jan;55(1):51-5. doi: 10.1053/crad.1999.0329.
To demonstrate the use of MRI with Gadolinium-DTPA enhancement in the diagnosis of giant cisterna chyli.
The study consisted of contrast enhanced MRI with ultrasound and CT correlation in three patients with a giant cisterna chyli. An analysis of the morphology, location and post-contrast MR signal characteristics in relation to time was performed.
Cisterna chyli has a characteristic lobulated morphology and location but the unenhanced MRI appearances are not specific. The post-Gadolinium-DTPA MRI appearances are critically dependent on the time elapsed after injection of contrast medium. Within the first 5 min, there is no enhancement at all, but by 10 min there is early layering of contrast medium evident, which by 30 min produces a clear fluid-fluid level. Delayed images at 4-5 h demonstrate a uniform enhancement of the cisternal contents producing a homogeneous intermediate signal. All of these features are best visualized on T1 fast saturation sequences.
MRI with Gadolinium-DTPA enhancement is valuable in confirming the nature of the lymphatic ducts in the retroperitoneal space and helps to differentiate these normal structures from alternative lesions such as lymphadenopathy and tumour recurrence.
证明钆喷酸葡胺增强磁共振成像（MRI）在巨大乳糜池诊断中的应用。
本研究包括对3例巨大乳糜池患者进行的对比增强MRI检查，并与超声和CT进行相关性分析。对其形态、位置以及对比剂注射后不同时间的磁共振信号特征进行了分析。
乳糜池具有特征性的分叶状形态和位置，但未增强的MRI表现不具有特异性。钆喷酸葡胺增强后的MRI表现严重依赖于注射对比剂后的时间。在最初5分钟内，完全没有强化，但到10分钟时，对比剂出现早期分层，到30分钟时形成清晰的液-液平面。4-5小时的延迟图像显示乳糜池内容物均匀强化，产生均匀的中等信号。所有这些特征在T1快速饱和序列上显示最佳。
钆喷酸葡胺增强MRI对于确认腹膜后间隙淋巴管的性质很有价值，有助于将这些正常结构与诸如淋巴结病和肿瘤复发等其他病变区分开来。
