MR淋巴管造影诊断婴儿乳糜胸一例及文献回顾（英文）
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摘要
乳糜胸在儿童胸腔积液中相对少见,而常规影像不能显示胸导管,要用影像方法发现外漏的部位很难做到,尤其在儿童更难。本文报告一例6个月乳糜胸患儿成功利用磁共振胰胆管成像序列(MRCP)及经足背皮内注射钆双铵行T_1WI频谱预饱和反转恢复序列(SPIR)行MR淋巴管造影发现胸导管外漏部位,提示该影像方法对于乳糜胸婴儿患者是简单而有效的胸导管检查方法。
Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography(MRL) using pre-contrast MR cholangiopancreatography(MRCP) and gadodiamideenhanced spectral presaturation inversion recovery(SPIR) T_1-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.
Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography(MRL) using pre-contrast MR cholangiopancreatography(MRCP) and gadodiamideenhanced spectral presaturation inversion recovery(SPIR) T_1-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.
引文
1.Yang J,Codreanu I,Zhuang H.Minimal lymphatic leakage in an infant with chylothorax detected by lymphoscintigraphy SPECT/CT.Pediatrics 2014;134:e606-10.doi:10.1542/peds.2013-2689.
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3.Dori Y,Zviman MM,Itkin M.Dynamic contrast-enhanced MR lymphangiography:feasibility study in swine.Radiology 2014;273:410-6.doi:10.1148/radiol.14132616.
4.Kiryu S,Inoue Y,Sheng F,Watanabe M,Yoshikawa K,Shimada M,et al.Interstitial MR lymphography in mice:comparative study with gadofluorine 8,gadofluorine M,and gadofluorine P.Magn Reson Med Sci 2012;11:99-107.doi:10.2463/mrms.11.99.
5.Yu DX,Ma XX,Zhang XM,Wang Q,Li CF.Morphological features and clinical feasibility of thoracic duct:detection with nonenhanced magnetic resonance imaging at 3.0 T.J Magn Reson Imaging 2010;32:94-100.doi:10.1002/jmri.22128.
6.Deso S,Ludwig B,Kabutey NK,Kim D,Guermazi A.Lymphangiography in the diagnosis and localization of various chyle leaks.Cardiovasc Intervent Radiol 2012;35:117-26.doi:10.1007/s00270-010-0066-x.
7.Ruehm SG,Schroeder T,Debatin JF.Interstitial MR lymphography with gadoterate meglumine:initial experience in humans.Radiology 2001;220:816-21.doi:10.1148/radiol.2203010090
8.Turkbey B,Kobayashi H,Hoyt RF Jr,Choyke PL,Nakajima T,Griffiths GL,et al.Magnetic resonance lymphography of the thoracic duct after interstitial injection of gadofosveset trisodium:a pilot dosing study in a porcine model.Lymphat Res Biol 2014;12:32-6.doi:10.1089/lrb.2013.0029.
2.Tan IC,Balaguru D,Rasmussen JC,Guilliod R,Bricker JT,Douglas WI,et al.Investigational lymphatic imaging at the bedside in a pediatric postoperative chylothorax patient.Pediatr Cardiol 2014;35:1295-300.doi:10.1007/s00246-014-0946-y.
3.Dori Y,Zviman MM,Itkin M.Dynamic contrast-enhanced MR lymphangiography:feasibility study in swine.Radiology 2014;273:410-6.doi:10.1148/radiol.14132616.
4.Kiryu S,Inoue Y,Sheng F,Watanabe M,Yoshikawa K,Shimada M,et al.Interstitial MR lymphography in mice:comparative study with gadofluorine 8,gadofluorine M,and gadofluorine P.Magn Reson Med Sci 2012;11:99-107.doi:10.2463/mrms.11.99.
5.Yu DX,Ma XX,Zhang XM,Wang Q,Li CF.Morphological features and clinical feasibility of thoracic duct:detection with nonenhanced magnetic resonance imaging at 3.0 T.J Magn Reson Imaging 2010;32:94-100.doi:10.1002/jmri.22128.
6.Deso S,Ludwig B,Kabutey NK,Kim D,Guermazi A.Lymphangiography in the diagnosis and localization of various chyle leaks.Cardiovasc Intervent Radiol 2012;35:117-26.doi:10.1007/s00270-010-0066-x.
7.Ruehm SG,Schroeder T,Debatin JF.Interstitial MR lymphography with gadoterate meglumine:initial experience in humans.Radiology 2001;220:816-21.doi:10.1148/radiol.2203010090
8.Turkbey B,Kobayashi H,Hoyt RF Jr,Choyke PL,Nakajima T,Griffiths GL,et al.Magnetic resonance lymphography of the thoracic duct after interstitial injection of gadofosveset trisodium:a pilot dosing study in a porcine model.Lymphat Res Biol 2014;12:32-6.doi:10.1089/lrb.2013.0029.