CT 淋巴管造影和 Tc-DX 淋巴闪烁显像对原发性乳糜性心包积液的诊断价值。

Diagnostic value of combined CT lymphangiography and Tc-DX lymphoscintigraphy in primary chylopericardium.

机构信息

Present address: Department of Radiology, Beijing Shijitan Hospital Affiliated to Capital Medical University, Yangfangdian Tieyi Road No.10, Haidian District, Beijing, 100038, China.

Department of Nuclear Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China.

出版信息

BMC Med Imaging. 2024 Aug 28;24(1):223. doi: 10.1186/s12880-024-01399-x.

DOI:10.1186/s12880-024-01399-x

PMID:39198752

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11350940/

Abstract

OBJECTIVE

To investigate the diagnostic value of combined Tc-DX lymphoscintigraphy and CT lymphangiography (CTL) in primary chylopericardium.

METHODS

Fifty-five patients diagnosed with primary chylopericardium clinically were retrospectively analyzed. Tc-DX lymphoscintigraphy and CTL were performed in all patients. Primary chylopericardium was classified into three types, according to the Tc-DX lymphoscintigraphy results. The evaluation indexes of CTL include: (1) abnormal contrast distribution in the neck, (2) abnormal contrast distribution in the chest, (3) dilated thoracic duct was defined as when the widest diameter of thoracic duct was > 3 mm, (4) abnormal contrast distribution in abdominal. CTL characteristics were analyzed between different groups, and P < 0.05 was considered a statistically significant difference.

RESULTS

Primary chylopericardium showed 12 patients with type I, 14 patients with type II, and 22 patients with type III. The incidence of abnormal contrast distribution in the posterior mediastinum was greater in type I than type III (P = 0.003). The incidence of abnormal contrast distribution in the pericardial and aortopulmonary windows, type I was greater than type III (P = 0.008). And the incidence of abnormal distribution of contrast agent in the bilateral cervical or subclavian region was greater in type II than type III (P = 0.002).

CONCLUSION

The combined application of the Tc-DX lymphoscintigraphy and CTL is of great value for the localized and qualitative diagnosis of primary chylopericardium and explore the pathogenesis of lesions.

摘要

目的

探讨 Tc-DX 淋巴闪烁显像和 CT 淋巴管成像（CTL）联合应用对原发性乳糜性心包积液的诊断价值。

方法

回顾性分析 55 例临床诊断为原发性乳糜性心包积液的患者。所有患者均行 Tc-DX 淋巴闪烁显像和 CTL 检查。根据 Tc-DX 淋巴闪烁显像结果，将原发性乳糜性心包积液分为 3 型。CTL 的评价指标包括：（1）颈部异常对比剂分布；（2）胸部异常对比剂分布；（3）胸导管扩张定义为胸导管最宽处直径＞3mm；（4）腹部异常对比剂分布。分析不同组之间 CTL 的特征，并认为 P＜0.05 为具有统计学意义的差异。

结果

原发性乳糜性心包积液患者中，I 型 12 例，II 型 14 例，III 型 22 例。I 型后纵隔异常对比剂分布的发生率高于 III 型（P=0.003）。I 型心包和主肺动脉窗异常对比剂分布的发生率高于 III 型（P=0.008）。II 型双侧颈区或锁骨下区异常对比剂分布的发生率高于 III 型（P=0.002）。