Value of CT lymphangiography combined with direct lymphangiography in diagnosing primary intestinal lymphangiectasia
10.3760/cma.j.issn.1005-1201.2017.05.008
- VernacularTitle:联合应用CT淋巴管成像与直接淋巴管造影诊断原发性小肠淋巴管扩张症的价值
- Author:
Jian DONG
;
Wenbin SHEN
;
Jianfeng XIN
;
Meng HUO
;
Chunyan ZHANG
;
Pengfei LIU
;
Tingguo WEN
;
Rengui WANG
;
Xiaobai CHEN
- Keywords:
Lymphangiectasis;
intestinal;
Tomography;
X-ray computed;
Lymphography;
Endoscopy;
digestive system
- From:
Chinese Journal of Radiology
2017;51(5):362-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of CT lymphangiography (CTL) combined with direct lymphangiography (DLG) in primary intestinal lymphangiectasia (PIL). Methods Sixteen patients diagnosed as PIL with intestinal enteroscopy were recruited in this retrospective study. All the patients were performed DLG and CTL one week before exploratory laparotomy. Subjective assessment in DLG included weak lymphatic fluid drainage, lymphangiectasia, lymphatic reflux, fistula and thoracic outlet reflux or obstruction. While for CTL combined with DLG, the intestinal and extra-intestinal lesions were evaluated, including lymph node, edema, lymphangiectasia and abnormal distribution, fistula, and lymphangiomatosis. All the diagnosis was compared with intestinal endoscopy results. Results For DLG, 16 weak lymphatic fluid drainages, 9 lymphangiectasia, 1 fistula with abdomen and 14 thoracic outlets weak lymphatic fluid drainage or obstruction were found. For DLG combined with CTL, 16 intestinal lumens dilatation and 14 circumferential intestinal thickening were found in intestinal lesions. While for extra-intestinal lesions, the imaging features included edematous findings (12 in mesentery, 7 ascites only, 2 hydrothorax and ascites, and 3 pericardial, thoracic and abdominal effusions), abdominal lymph nodes (6 cases), lymphangiectasia and abnormal distributions (14 cases), fistulas (lymph-intestinal luminal fistula in 4 cases, and lymph-abdominal fistula in 3 cases), lymphangiomatosis (3 cases), and thoracic duct outlet dysfunction and reflux (14 cases).The number of cases diagnosed as intestinal lymphangiectasia, intestinal luminal lymph exudation and lymph fistula were 16, 10 and 6 with intestinal endoscopy, while the number were 11, 0, and 4 with CTL combination with DLG. Conclusion Combination of CTL with DLG is valuable in the diagnosis of PIL.
