Parasher Vinod K, Hernandez Lyndon V, Leveen Robert F, Mladinich Christopher R J, Nonabur Venkatesh, Bhutani Manoop S
Helen F. Graham Cancer Center, Christiana Care Hospital, Newark, Delaware 19958, USA.
Gastrointest Endosc. 2004 Apr;59(4):564-7. doi: 10.1016/s0016-5107(03)02880-3.
The thoracic duct plays an important role in fluid balance, lipid absorption, and transport of immunologically active cells. The thoracic duct is difficult to access but is readily identified by EUS. The present study assessed the feasibility of EUS identification and EUS-guided puncture of the thoracic duct in a swine model.
Transesophageal EUS-guided thoracic duct puncture was attempted in 3 animals under fluoroscopy. In two animals, the thoracic duct was identified by cutdown in the neck; in the third animal, EUS-guided puncture was performed under fluoroscopy alone. In one animal, the thoracic duct was opacified by injecting contrast medium. In the second animal, thoracic duct was injected with patent blue and contrast medium.
Thoracic duct was identified and punctured successfully in all 3 animals. In the first animal, contrast medium containing lymph was aspirated. In the second animal, lymph containing patent blue was aspirated, and, in the third animal, successful puncture was confirmed by obtaining a lymphangiogram.
This pilot study in an animal model demonstrates that transesophageal EUS-guided puncture of the thoracic duct is feasible and that the technique can be used for lymph sampling and/or lymphangiography.
胸导管在液体平衡、脂质吸收及免疫活性细胞运输中发挥着重要作用。胸导管难以触及，但可通过超声内镜（EUS）轻松识别。本研究评估了在猪模型中进行EUS识别及EUS引导下胸导管穿刺的可行性。
在透视引导下，对3只动物尝试经食管EUS引导的胸导管穿刺。在2只动物中，通过颈部切开术识别胸导管；在第3只动物中，仅在透视下进行EUS引导的穿刺。在1只动物中，通过注射造影剂使胸导管显影。在第2只动物中，向胸导管注射专利蓝和造影剂。
所有3只动物的胸导管均被成功识别并穿刺。在第1只动物中，吸出了含淋巴液的造影剂。在第2只动物中，吸出了含专利蓝的淋巴液，在第3只动物中，通过获得淋巴管造影证实穿刺成功。
该动物模型的初步研究表明，经食管EUS引导的胸导管穿刺是可行的，该技术可用于淋巴采样和/或淋巴管造影。
