GIÁ TRỊ CỦA PHƯƠNG PHÁP CHỤP CỘNG HƯỞNG TỪ BẠCH MẠCH QUA HẠCH BẸN TRONG ĐÁNH GIÁ GIẢI PHẪU VÀ CHẨN ĐOÁN RÒ ỐNG NGỰC

Abstract

Purpose: To compare the value of intranodal dynamic magnetic resonance lymphangiography (DMRL) with Digital subtraction lymphagiography (DSA) in identifying anatomy and diagnosing thoracic duct leakage. Materials and methods: 42 patients diagnosed with chylous leak (26 women, 16 men; 35 traumatic chylous, 7 nontraumatic chylous) underwent intranodal DMRL and DSA at Radiology center of Hanoi Medical University Hospital. Results: The most common locations of thoracic duct injury were the neck segment in 19/42 patients (45%) and the thoracic segment with 16/42 patients (38%). Anatomical evaluation revealed that 50% of patients had a normal thoracic duct anatomy, while 33.3% lacked a cisterna chyli. Comparing the anatomical assessment capabilities of DMRL and DSA showed a high level of agreement for normal anatomy, a completely left-sided thoracic duct, absence of cisterna chyli, and distal partial duplication of the thoracic duct. Regarding the ability to detect fistula, DMRL compared with DSA has a sensitivity of 92%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 57%. Conclusion: Intranodal dynamic magnetic resonance lymphangiography is a minimally invasive, radiation-free technique that provides comprehensive anatomical information as well as high sensitivity and specificity in detecting thoracic duct leak.