Johnson Eric G, Wisner Erik R, Kyles Andrew, Koehler Carl, Marks Stanley L
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA.
Vet Surg. 2009 Apr;38(3):361-7. doi: 10.1111/j.1532-950X.2008.00473.x.
To document a novel technique to image the thoracic duct and its tributaries by contrast enhanced computed tomography (CT) lymphography.
Clinical report.
Dogs (n=6) idiopathic chylothorax.
Ultrasonography was used to guide percutaneous injection of intestinal lymph nodes with nonionic iodinated contrast medium for preoperative CT lymphography of the thoracic duct in 6 dogs with chylothorax. Thoracic CT images were acquired immediately after contrast medium injection. All dogs had subtotal pericardectomy and thoracic duct ligation. Postoperative thoracic duct lymphography was performed in 3 dogs. Superficial cervical lymph node lymphography was performed in 2 dogs to determine cervical lymphatic contribution to thoracic effusions.
Preoperative thoracic duct lymphography using this technique was successful in delineating the cisterna chyli, thoracic duct, and associated lymphatic vessels in all dogs. Immediate postoperative lymphography performed in 2 dogs revealed successful duct ligation in 1 dog and persistent lymphatic leakage in the other. A 1-month postoperative thoracic duct lymphogram performed in 1 dog revealed unsuccessful ligation or recannulation of 1 of 3 redundant vessels seen preoperatively.
Percutaneous CT lymphography results in excellent detection of the thoracic duct and abnormal thoracic duct drainage patterns both pre- and postoperatively. The contribution of superficial cervical lymph node drainage to reoccurrence of effusions can be evaluated.
Percutaneous CT lymphography using ultrasound-guided contrast medium injection should be considered as an alternative to conventional open abdominal approaches to radiographic or CT lymphography.
记录一种通过对比增强计算机断层扫描（CT）淋巴造影对胸导管及其分支进行成像的新技术。
临床报告。
患有特发性乳糜胸的犬（n = 6）。
使用超声引导经皮向肠淋巴结注射非离子型碘化造影剂，对6只乳糜胸犬进行术前胸导管CT淋巴造影。造影剂注射后立即采集胸部CT图像。所有犬均接受心包次全切除术和胸导管结扎术。3只犬术后进行了胸导管淋巴造影。2只犬进行了颈浅淋巴结淋巴造影以确定颈部淋巴对胸腔积液的影响。
使用该技术进行的术前胸导管淋巴造影成功描绘了所有犬的乳糜池、胸导管及相关淋巴管。2只犬术后立即进行的淋巴造影显示，1只犬胸导管结扎成功，另1只犬持续存在淋巴漏。1只犬术后1个月的胸导管淋巴造影显示，术前可见的3条多余血管中有1条结扎或再通失败。
经皮CT淋巴造影能很好地检测术前和术后的胸导管及异常的胸导管引流模式。可评估颈浅淋巴结引流对积液复发的影响。
使用超声引导造影剂注射的经皮CT淋巴造影应被视为传统开放性腹部放射造影或CT淋巴造影方法的替代方案。
