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超声分析缩窄性心包炎并乳糜胸患者的颈胸导管。

Ultrasound analysis of cervical thoracic duct for patients with constrictive pericarditis and chylothorax.

机构信息

Department of Ultrasonography, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

J Clin Ultrasound. 2024 Jun;52(5):529-534. doi: 10.1002/jcu.23671. Epub 2024 Mar 12.

Abstract

PURPOSE

To analyze ultrasound features of cervical thoracic duct for patients with constrictive pericarditis and chylothorax.

METHODS

Patients were retrospectively assessed. The patients were divided into a non-pleural effusion (PE) group (n = 54), a chylothorax group (n = 23), and non-chylothorax group (n = 28). Conventional ultrasound was used to obtain the maximum inner diameter and collapse of the inferior vena cava, the inner diameter of left cervical thoracic duct, and the frequency of opening of the valve at the end of the left thoracic duct. Contrast ultrasonography was used to score the reverse flow of the thoracic tube.

RESULTS

The percentage of PE was 48.5%, and the percentage of chylothorax was 21.9%. The three groups had significant differences in five parameters. The inner diameter of left cervical thoracic duct was correlated with the degree of central venous pressure. Contrast ultrasonography was effective in quantitative assessment of the degree of intravenous-thoracic cord reverse flow which correlated with all parameters of central venous pressure.

CONCLUSION

Thoracic duct dilation and regurgitation secondary to central venous pressure can lead to chyloreflux disorder and may be the mechanism of chylothorax occurrence in constrictive pericarditis.

摘要

目的

分析缩窄性心包炎合并乳糜胸患者颈胸导管的超声特征。

方法

对患者进行回顾性评估。患者分为无胸腔积液(PE)组(n=54)、乳糜胸组(n=23)和非乳糜胸组(n=28)。常规超声获取下腔静脉最大内径和塌陷率、左颈胸导管内径和左胸导管末端瓣膜开放频率,对比超声检查胸导管反流评分。

结果

胸腔积液的百分比为 48.5%,乳糜胸的百分比为 21.9%。三组在五个参数上有显著差异。左颈胸导管内径与中心静脉压程度相关。对比超声检查在定量评估静脉-胸导管反向流动方面是有效的,与中心静脉压的所有参数均相关。

结论

中心静脉压导致的胸导管扩张和反流可导致乳糜反流紊乱,可能是缩窄性心包炎发生乳糜胸的机制。

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