ĐẶC ĐIỂM HÌNH ẢNH CỘNG HƯỞNG TỪ BẠCH MẠCH Ở BỆNH NHÂN TIỂU DƯỠNG CHẤP

Abstract

Overview: Chyluria is a common manifestation of lymphatic system lesion, caused by communication between lymphatic branches and the urinary system. Object: To evaluate the characteristics of magnetic resonance imaging (MRI) of the lymphatic system with the injection of paramagnetic contrast agents through the inguinal lymph nodes to identify the cause and the location of the lesion. Subjects and methods: The study was conducted on 41 patients diagnosed with chyluria through clinical examination, cystoscopy and urinary triglyceride testing. All patients underwent magnetic resonance imaging of the lymphatic system with the injection of paramagnetic contrast agents through the inguinal lymph nodes. Results: The average age of 65,9 years, with a male to female ratio of 1:2. Magnetic resonance imaging showed 100% visualization of the lumbar lymphatic trunk, thoracic duct, 92.8% of the urinary bladder, and detected 97.6% of patients with fistula branches into the renal pelvis, of which the majority of patients had communication of lymphatic branches into the left renal pelvis with 56.1%. In terms of the ability to detect fistula, MRI compared to cystoscopy had a sensitivity of 100%, a specificity of 25%, a positive predictive value of 92.5%, and a negative predictive value of 100%. In terms of the ability to detect fistula, MRI compared to Digital subtraction lymphagiography (DSA) had a sensitivity and specificity of 100%, a positive predictive value of 100% and a negative predictive value of 100%.