ĐẶC ĐIỂM HÌNH ẢNH CỘNG HƯỞNG TỪ BẠCH MẠCH CÓ TIÊM THUỐC ĐỐI QUANG TỪ QUA HẠCH BẸN Ở BỆNH NHÂN RÒ DƯỠNG CHẤP SAU PHẪU THUẬT UNG THƯ TUYẾN GIÁP

Abstract

Purpose: To report the imaging of intranodal dynamic magnetic resonance lymphangiography (DMRL) through bilateral inguinal lymph nodes in detecting chylous leakage in patients post thyroidectomy due to thyroid cancer. Materials and methods: 39 patients diagnosed with chylous leak (32 women, 6 men) underwent intranodal dynamic magnetic resonance lymphangiography (DMRL) through bilateral inguinal lymph nodes at the Radiology center of Hanoi Medical University Hospital from January 2019 to August 2023. Results: The anatomical characteristics of the central lymphatic system: the average transverse diameter of the thoracic duct is 4.0 ± 0.2mm, 95% of the patients with the thoracic duct have a diameter between 2.9 - 5.8mm. The most common position of the chylous cistern is at the level of the D12 – L1 vertebrae (52.9%), the anatomical variant of the thoracic duct accounted for 55.3%, the variant without the chylous cistern accounted for 55.3%. The most common inflow site of the thoracic duct is on the left side, accounting for 89.50% (of which 28.95% can't see a specific infusion site into the venous system), both sides account for 10.50% and there is no case of thoracic duct inflow right. The specific drainage site of the thoracic duct into the subclavian vein was the most common with 44.5%, the second was the confluence of the internal jugular-subclavian vein with 40.7%, at least common was the internal jugular vein with 14.8%. Characteristics of thoracic duct lesions: 33 cases (86.8%) were detected, and the remaining 5 cases (13.2%) were not detected. The location of damage to the terminal branch accounted for 60.5%, the lateral branch was 26.3%, and 13.2% was undetected. The most common form of lesion is drainage of contrast medium, accounting for ~84.2%, pseudoaneurysm for 2.6%, undetected accounted for 13.2%. Conclusion: Intranodal dynamic magnetic resonance lymphangiography (DMRL) through bilateral inguinal lymph nodes is a technique with many advantages. Points about detecting the location and morphology of thoracic duct lesions and providing valuable information on imaging characteristics of the central lymphatic system.