Li Xing-Peng, Zhang Yan, Sun Xiao-Li, Hao Kun, Liu Meng-Ke, Hao Qi, Wang Ren-Gui
Department of Radiology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China.
Department of Radiology, Qilu Hospital, Shandong University, Jinan 250063, Shandong Province, China.
World J Clin Cases. 2024 May 16;12(14):2350-2358. doi: 10.12998/wjcc.v12.i14.2350.
This study presents an evaluation of the computed tomography lymphangiography (CTL) features of lymphatic plastic bronchitis (PB) and primary chylothorax to improve the diagnostic accuracy for these two diseases.
To improve the diagnosis of lymphatic PB or primary chylothorax, a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.
The clinical and CTL data of 71 patients (20 with lymphatic PB, 41 with primary chylothorax, and 10 with lymphatic PB with primary chylothorax) were collected retrospectively. CTL was performed in all patients. The clinical manifestations, CTL findings, and conventional chest CT findings of the three groups of patients were compared. The chi-square test or Fisher's exact test was used to compare the differences among the three groups. A difference was considered to be statistically significant when < 0.05.
(1) The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows: Thoracic duct outlet in 14 (70.0%), 33 (80.5%) and 8 (80.0%) patients; peritracheal region in 18 (90.0%), 15 (36.6%) and 8 (80.0%) patients; pleura in 6 (30.0%), 33 (80.5%) and 9 (90.0%) patients; pericardium in 6 (30.0%), 6 (14.6%) and 4 (40.0%) patients; and hilum in 16 (80.0%), 11 (26.8%) and 7 (70.0%) patients; and (2) the abnormalities on conventional chest CT in the three groups were as follows: Ground-glass opacity in 19 (95.0%), 18 (43.9%) and 8 (80.0%) patients; atelectasis in 4 (20.0%), 26 (63.4%) and 7 (70.0%) patients; interlobular septal thickening in 12 (60.0%), 11 (26.8%) and 3 (30.0%) patients; bronchovascular bundle thickening in 14 (70.0%), 6 (14.6%) and 4 (40.0%) patients; localized mediastinal changes in 14 (70.0%), 14 (34.1%), and 7 (70.0%) patients; diffuse mediastinal changes in 6 (30.0%), 5 (12.2%), and 3 (30.0%) patients; cystic lesions in the axilla in 2 (10.0%), 6 (14.6%), and 2 (20.0%) patients; and cystic lesions in the chest wall in 0 (0%), 2 (4.9%), and 2 (4.9%) patients.
CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax. This method is an excellent tool for diagnosing these two diseases.
本研究对淋巴性塑料支气管炎（PB）和原发性乳糜胸的计算机断层扫描淋巴管造影（CTL）特征进行评估，以提高对这两种疾病的诊断准确性。
为提高淋巴性PB或原发性乳糜胸的诊断水平，对71例诊断为淋巴性PB或原发性乳糜胸患者的临床特征和CTL特征进行回顾性分析。
回顾性收集71例患者（20例淋巴性PB、41例原发性乳糜胸、10例淋巴性PB合并原发性乳糜胸）的临床和CTL数据。所有患者均行CTL检查。比较三组患者的临床表现、CTL表现及常规胸部CT表现。采用卡方检验或Fisher精确检验比较三组间差异。P<0.05时差异具有统计学意义。
（1）三组患者CTL上异常造影剂沉积的百分比分别为：胸导管出口处14例（70.0%）、33例（80.5%）和8例（80.0%）；气管周围区域18例（90.0%）、15例（36.6%）和8例（80.0%）；胸膜6例（30.0%）、33例（80.5%）和9例（90.0%）；心包6例（30.0%）、6例（14.6%）和4例（40.0%）；肺门16例（80.0%）、11例（26.8%）和7例（70.0%）；（2）三组患者常规胸部CT上的异常表现分别为：磨玻璃影19例（95.0%）、18例（43.9%）和8例（80.0%）；肺不张4例（20.0%）、26例（63.4%）和7例（70.0%）；小叶间隔增厚12例（60.0%）、11例（26.8%）和3例（30.0%）；支气管血管束增粗14例（70.0%）、6例（14.6%）和4例（40.0%）；局限性纵隔改变14例（70.0%）、14例（34.1%）和7例（70.0%）；弥漫性纵隔改变6例（30.0%）、5例（12.2%）和3例（30.0%）；腋窝囊性病变2例（10.0%）、6例（14.6%）和2例（20.0%）；胸壁囊性病变0例（0%）、2例（4.9%）和2例（4.9%）。
CTL非常适合于明确淋巴性PB和原发性乳糜胸的特征。该方法是诊断这两种疾病的优秀工具。
