Yura Ahn, Hyun Jung Koo, Jooae Choe, Jong Eun Lee, Dong Hyun Yang, Joon-Won Kang, Ji Hoon Shin
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Abstract
Lymphatic leakage, manifesting as chylothorax or chylous ascites, arises from traumatic or nontraumatic causes and poses severe risks such as malnutrition and increased infection susceptibility. Accurate diagnosis and an effective treatment strategy necessitate comprehensive lymphatic imaging. Conventional lymphangiography and dynamic contrast-enhanced MR lymphangiography (DCMRL) have been widely used and studied as effective lymphatic imaging methods. Recently, CT lymphangiography (CTL) has been successfully implemented in animal studies and some patients, and the authors' institution now prioritizes CTL over DCMRL. Contrast-enhanced CTL offers a promising alternative, with advantages such as better accessibility and faster imaging. These advantages of CTL over traditional methods highlight its superior accessibility and fast acquisition time. Moreover, to reduce and optimize radiation dose, the stepwise propagation scanning method in CTL could be used, which is especially beneficial in pediatric patients. In this review, the authors suggest the protocol for CTL and interpretation methods for evaluation and therapeutic planning of central lymphatic disorders, focusing on the condition of lymphatic leakage. © RSNA, 2024 The slide presentation from the RSNA Annual Meeting is available for this article.
对比增强 CT 淋巴管造影术治疗各种中央淋巴系统疾病
淋巴渗漏表现为乳糜胸或乳糜腹水,可由外伤或非外伤原因引起,并带来严重的风险,如营养不良和感染易感性增加。准确的诊断和有效的治疗策略需要全面的淋巴成像。传统淋巴管造影术和动态对比增强磁共振淋巴管造影术(DCMRL)作为有效的淋巴管造影方法已被广泛应用和研究。最近,CT淋巴管造影(CTL)已成功应用于动物实验和部分患者,作者所在机构目前优先考虑 CTL 而非 DCMRL。对比增强 CTL 提供了一种前景广阔的替代方法,其优点是更容易获得和成像更快。与传统方法相比,CTL 的这些优势突出表现在其更好的可及性和更快的采集时间。此外,为了减少和优化辐射剂量,可在 CTL 中使用分步传播扫描方法,这对儿科患者尤其有益。在这篇综述中,作者提出了 CTL 的方案和解读方法,用于评估和制定中央淋巴系统疾病的治疗计划,重点关注淋巴漏的情况。©RSNA,2024 RSNA 年会的幻灯片演示可用于本文。
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