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Date Published: 23/12/2021
Abstract Views: 269
Views PDF: 180
DOI: https://doi.org/10.51298/vmj.v507i2.1391
Issue
Vol. 507 No. 2 (2021)
Section
Các bài báo
How to Cite
Nguyễn Khánh Chi, T. ., Ngọc Cương, N. ., Tuấn Linh, L. ., & Hồng Cảnh, P. . (2021). VALUE OF INTRANODAL DYNAMIC MAGNETIC RESONANCE LYMPHAGIOGRAPHY (DMRL) IN DETECTING THORACIC DUCT LEAK. Vietnam Medical Journal, 507(2). https://doi.org/10.51298/vmj.v507i2.1391

VALUE OF INTRANODAL DYNAMIC MAGNETIC RESONANCE LYMPHAGIOGRAPHY (DMRL) IN DETECTING THORACIC DUCT LEAK

Trần Nguyễn Khánh Chi1,, Nguyễn Ngọc Cương2, Lê Tuấn Linh2, Phạm Hồng Cảnh2
1 Hanoi Medical University
2 Hanoi Medical University Hospital

Main Article Content

Abstract

Purpose: To compare the value of intranodal dynamic magnetic resonance lymphagiography (DMRL) with Digital subtraction lymphagiography (DSA) in detecting thoracic duct leak. Materials and methods: 25 patients diagnosed with chylous leak (18 women, 7 men; 21 traumatic chylous, 4 nontraumatic chylous) underwent intranodal dynamic magnetic resonancce lymphagiography and digital subtraction lymphagiography at Radiology center of Hanoi Medical University Hospital from June 2019 to August 2021. Results: The results showed that the common locations of thoracic duct injury were the neck segment in 12/25 patients (48%) and the thoracic segment with 10/25 patients (40%). The most common form of thoracic duct lesions was extravation in 18/25 patients (72%). With lateral branch lesion morphology, DMRL compared with DSA has a sensitivity of 60%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 91%. Regarding the ability to detect fistula, DMRL compared with DSA has a sensitivity of 91.7%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 33.3%. Conclusion: Intranodal dynamic magnetic resonancce lymphagiography is a technique that has many advantages compared to previous methods of imaging the lymphatic system, with high sensitivity and specificity in detecting thoracic duct leak.

Article Details

Keywords

MR lymphagiography, thoracic duct, chyle leak

References

1. Johnson OW, Chick JFB, Chauhan NR, et al. The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol. 2016;26(8):2482-2493. doi:10.1007/s00330-015-4112-6
2. Bolger C, Walsh TN, Tanner WA, Keeling P, Hennessy TPJ. Chylothorax after oesophagectomy. British Journal of Surgery. 2005;78(5): 587 - 588. doi: 10.1002/bjs. 1800780521
3. Itkin M, Nadolski GJ. Modern Techniques of Lymphangiography and Interventions: Current Status and Future Development. Cardiovasc Intervent Radiol. 2018;41(3):366-376. doi:10.1007/s00270-017-1863-2
4. Chen E, Itkin M. Thoracic Duct Embolization for Chylous Leaks. Semin Intervent Radiol. 2011;28(1):63-74. doi:10.1055/s-0031-1273941
5. Majdalany BS, El-Haddad G. Contemporary lymphatic interventions for post-operative lymphatic leaks. Transl Androl Urol. 2020;9(S1):S104-S113. doi:10.21037/tau.2019.08.15
6. Pamarthi V, Pabon-Ramos WM, Marnell V, Hurwitz LM. MRI of the Central Lymphatic System: Indications, Imaging Technique, and Pre-Procedural Planning. Top Magn Reson Imaging. 2017;26(4):175-180. doi:10.1097/RMR.0000000000000130
7. Munn LL, Padera TP. Imaging the lymphatic system. Microvasc Res. 2014;0:55-63. doi:10.1016/j.mvr.2014.06.006
8. Itkin M, Kucharczuk JC, Kwak A, Trerotola SO, Kaiser LR. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: Experience in 109 patients. The Journal of Thoracic and Cardiovascular Surgery. 2010;139(3):584-590. doi:10.1016/j.jtcvs.2009.11.025