Xin Jian-feng, Sun Yu-guang, Xia Song, Chang Kun, Zhu Yan, Liu Xin, An Ran, Shen Wen-bin
Department of Lymphatic Surgery, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Zhonghua Yi Xue Za Zhi. 2013 Jul 23;93(28):2212-4.
To discuss the role of direct lymphangiography in the diagnosis of primary chyluria.
Iodized oil was infused into lymphatic vessel of unilateral foot in 25 cases. The condition of lymphatic system imaging was dynamically observed via Innova 2100-IQ digital flat-panel angiography system.
All of them underwent direct lymphangiography. The results revealed unilateral (n = 18) or bilateral (n = 7) renal reflux of contrast media. Among 22 stenotic cases, there were partial (n = 18) or whole (n = 4) cervical section of thoracic duct, no imaging in cervicothoracic section of thoracic duct (n = 1); thin imaging in cervical section and partial thoracic section (n = 2); retroperitoneal lymphangictasia & tortuous lymphatic vessels (n = 21); reflux of contrast medium to pelvic and/or contralateral sacroiliac part (n = 13).
Capable of acquiring dynamic images of chyle (lymph) circulation, direct lymphangiography provides accurate estimation for the location, scope, extent of lesions of renal chylous reflux in primary chyluria so as to guide surgery. Stenotic cervical section of thoracic duct plays an important etiologic role in primary chyluria.
探讨直接淋巴管造影在原发性乳糜尿诊断中的作用。
对25例患者单侧足部淋巴管注入碘化油，通过Innova 2100-IQ数字平板血管造影系统动态观察淋巴系统显影情况。
25例均行直接淋巴管造影，结果显示造影剂单侧（18例）或双侧（7例）肾逆流。22例狭窄病例中，胸导管颈部部分（18例）或全部（4例）狭窄，胸导管颈胸段未显影（1例）；颈段及部分胸段显影淡薄（2例）；腹膜后淋巴管扩张及淋巴管迂曲（21例）；造影剂反流至盆腔和/或对侧骶髂部（13例）。
直接淋巴管造影能够获取乳糜（淋巴）循环的动态图像，对原发性乳糜尿中肾乳糜反流病变的部位、范围、程度进行准确判断，从而指导手术。胸导管颈部狭窄在原发性乳糜尿发病中起重要作用。
