ISSN 1004-4140
CN 11-3017/P
Volume 31 Issue 4
Aug.  2022
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ZHANG Y, HAO Q, LIU M K, et al. Application of CT lymphangiography in diagnosing primary pulmonary lymphedema[J]. CT Theory and Applications, 2022, 31(4): 441-447. DOI: 10.15953/j.ctta.2022.096. (in Chinese)
Citation: ZHANG Y, HAO Q, LIU M K, et al. Application of CT lymphangiography in diagnosing primary pulmonary lymphedema[J]. CT Theory and Applications, 2022, 31(4): 441-447. DOI: 10.15953/j.ctta.2022.096. (in Chinese)

Application of CT Lymphangiography in the Diagnosiis of Primary Pulmonary Lymphedema

doi: 10.15953/j.ctta.2022.096
  • Received Date: 2022-05-25
  • Accepted Date: 2022-07-01
  • Rev Recd Date: 2022-06-30
  • Available Online: 2022-07-07
  • Publish Date: 2022-08-01
  • Objective: To explore the clinical value of CT lymphangiography in diagnosing primary pulmonary lymphedema. Methods: 52 patients who were diagnosed by clinical, imaging and pathology as primary pulmonary lymphedema were analyzed retrospectively. All patients underwent CT lymphangiography. Two experienced radiologists carried out double-blind film reading of the CT lymphangiography manifestations, and observed the abnormal perfomance of lymphatic vessels in the chest as well as CT signs of other chest diseases.Results: CT lymphangiography showed contrast agent abnormity deposited in all 52 patients: the end of thoracic duct was found in 38 cases (73.1%), mediastinum in 34 cases (65.4%), hilar in 22 cases (42.3%), pleura in 18 cases (34.6%), pericardium in 15 cases (28.8%), diaphragm in 5 cases (9.6%), hepatic hilum in 9 cases (17.3%), pancreas in 5 cases (9.6%), retroperitoneum in 12 cases (23.1%). Abnormal CT changes including: (1) alveolar nodule-like ground glass opacity in 19 cases (36.5%), patchy ground glass opacity in 23 cases (44.2%), atelectasis in 11 cases (21.2%), pulmonary nodules in 3 cases (5.8%). (2) the thickening of bronchovascular bundle in 43 cases (82.7%), the thickening of interlobular septum in 43 cases (82.7%), the thickening of intralobular interstitium in 4 cases (7.7%), frog-spawn sign in 7 cases (13.5%). (3) abnormal mediastinum changes in 34 cases (65.4%). (4) other chest CT abnormalities including: the crazy-paving sign in 2 cases (3.8%), pleural effusion in 18 cases (34.6%), pericardial effusion in 18 case (34.6%). Conclusion: CT lymphangiography can indirectly predict the abnormality of lymphatics and the presence or absence of lymphatic reflux by showing the abnormal deposition and distribution of contrast agents, and thus can provide valuable imaging basis for the diagnosis and treatment of primary pulmonary lymphedema.

     

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  • [1]
    MIYOSHI K, NAKAGAWA T, KOKADO Y, et al. Primary chylopericardium with pulmonary lymphedema[J]. The Thoracic and Cardiovascular Surgeon, 2008, 56(5): 306−308. doi: 10.1055/s-2006-955952
    [2]
    AVERYANOV A V, BALIONIS O I, DIVAKOVA T I, et al. Severe pulmonary lymphedema in a patient with diffuse pulmonary lymphangiomatosis[J]. American Journal of Respiratory and Critical Care Medicine, 2019, 200(9): e91−e92. doi: 10.1164/rccm.201901-0062IM
    [3]
    MONROE E J. Brief description of ISSVA classification for radiologists[J]. Techniques in Vascular and Interventional Radiology, 2019, 22(4): 100628. doi: 10.1016/j.tvir.2019.100628
    [4]
    邓燕, 汤昆, 赵建平, 等. 淋巴管平滑肌瘤病合并乳糜肺炎1例[J]. 中华内科杂志, 2020,59(5): 387−390. DOI: 10.3760/cma.j.cn112138-20200226-00134.

    DENG Y, TANG K, ZHAO J P, et al. A case of lymphangiomyomatosis accompanied with chylous pneumonia[J]. Chinese Journal of Internal Medicine, 2020, 59(5): 387−390. DOI: 10.3760/cma.j.cn112138-20200226-00134. (in Chinese).
    [5]
    华菲, 沈振亚, 余云生, 等. 乳糜性心包积液并乳糜肺炎1例[J]. 中华胸心血管外科杂志, 2011,27(1): 38. doi: 10.3760/cma.j.issn.1001-4497.2011.01.014
    [6]
    SHINOHARA S, NAKANISHI R, YASUDA M, et al. Rapid growing pulmonary cavernous lymphangioma after chronic process for ten years[J]. International Journal of Surgery Case Reports, 2016, 27: 144−146. doi: 10.1016/j.ijscr.2016.08.033
    [7]
    王春华, 姚建国. 肺淋巴管瘤病11例临床病理分析[J]. 临床与实验病理学杂志, 2017,33(9): 1019−1021. doi: 10.13315/j.cnki.cjcep.2017.09.018
    [8]
    OZEKI M, FUJINO A, MATSUOKA K, et al. Clinical features and prognosis of generalized lymphatic anomaly, kaposiform lymphangiomatosis, and Gorham-Stout disease[J]. Pediatric Blood & Cancer, 2016, 63(5): 832−838.
    [9]
    MÄKINEN T, BOON L M, VIKKULA M, et al. Lymphatic malformations: Genetics, mechanisms and therapeutic strategies[J]. Circulation Research, 2021, 129(1): 136−154. doi: 10.1161/CIRCRESAHA.121.318142
    [10]
    王仁贵, 陈孝柏, 段永利, 等. MSCT直接淋巴管造影在弥漫性肺淋巴管瘤病中的诊断价值[J]. 中国医学影像技术, 2012,28(2): 185−189. DOI: 10.13929/j.1003-3289.2012.02.046.

    WANG R G, CHEN X B, DUAN Y L, et al. Diagnostic value of MSCT direct lymphangiography in diffuse pulmonary lymphangiomatosis[J]. Chinese Journal of Medical Imaging Technology, 2012, 28(2): 185−189. DOI: 10.13929/j.1003-3289.2012.02.046. (in Chinese).
    [11]
    ITKIN M G, MCCORMACK F X, DORI Y. Diagnosis and treatment of lymphatic plastic bronchitis in adults using advanced lymphatic imaging and percutaneous embolization[J]. Annals of the American Thoracic Society, 2016, 13(10): 1689−1696.
    [12]
    O'LEARY C N, KHADDASH T, NADOLSKI G, et al. Abnormal pulmonary lymphatic flow on novel lymphangiographic imaging supports a common etiology of lymphatic plastic bronchitis and nontraumatic chylothorax[J]. Lymphatic Research and Biology, 2022, 20(2): 153−159. doi: 10.1089/lrb.2021.0008
    [13]
    ITKIN M. Interventional treatment of pulmonary lymphatic anomalies[J]. Techniques in Vascular and Interventional Radiology, 2016, 19(4): 299−304. doi: 10.1053/j.tvir.2016.10.005
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