Visualization and prediction of the pleura and thoracic duct: elucidation of changes due to respiration using arterial landmarks and CT images.

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-02-07 DOI:10.1007/s00276-025-03582-3

Niina Hirano, Satoru Muro, Junichi Tsuchiya, Keiichi Akita

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引用次数: 0

Abstract

Purpose: The thoracic duct uses the pulsation of accompanying arteries to facilitate lymphatic flow. However, the lymphatic flow mechanism cannot be explained when it does not accompany the arteries. This study aimed to clarify the anatomical position of the thoracic duct and surrounding structures and determine the differences in the thoracic duct length and course during inspiration and expiration.

Methods: Six cadavers were dissected to observe the positional relationship between the thoracic duct and surrounding structures. Image sequences of anatomical sections from the Visible Korean Human Open Resource were observed and reconstructed to understand their three-dimensional positioning. Inspiratory and expiratory computed tomography scans were used to measure and examine respiratory variations in the distance between the arterial landmarks to predict the thoracic duct length.

Results: The thoracic duct accompanied the arteries for most of its course and was sandwiched between the arteries and pleura, entering the mediastinum. However, there was an area on the cranial side of the aortic arch where the thoracic duct did not accompany the arteries. The distance between the arterial landmarks in this area, which approximate the thoracic duct length, was significantly longer during inspiration (39.3 ± 7.81 mm) than during expiration (31.49 ± 7.01 mm).

Conclusion: This study suggests that the pleura entering the mediastinum pushes the thoracic duct toward the arteries to promote lymphatic flow generation by arterial pulsation. Additionally, this study suggests that the lymphatic flow in the thoracic duct is generated by the expansion and contraction of the thoracic duct with respiratory movement.

查看原文本刊更多论文

胸膜和胸导管的可视化和预测：利用动脉标志和CT图像阐明呼吸引起的变化。

目的：胸导管利用伴行动脉的搏动促进淋巴流动。然而，当淋巴流动不伴随动脉时，其机制就无法解释。本研究旨在明确胸导管及其周围结构的解剖位置，并确定吸气和呼气时胸导管长度和路径的差异。方法：对6具尸体进行解剖，观察胸导管与周围结构的位置关系。对可见韩国人开放资源的解剖切片图像序列进行观察和重建，以了解其三维定位。吸气和呼气计算机断层扫描用于测量和检查动脉标志之间距离的呼吸变化，以预测胸导管长度。结果：胸导管大部分时间伴行动脉，夹在动脉与胸膜之间，进入纵隔。然而，在主动脉弓的颅侧有一个区域，胸导管没有伴随动脉。吸气时（39.3±7.81 mm）明显长于呼气时（31.49±7.01 mm），与胸导管长度相近。结论：本研究提示进入纵隔的胸膜将胸导管推向动脉，促进动脉搏动产生淋巴流。此外，本研究提示胸导管的淋巴流是由呼吸运动时胸导管的扩张和收缩产生的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.