The application of non-enhanced magnetic resonance thoracic ductography combined with magnetic resonance abdominopelvic scanning in the diagnosis of chylous leakage of the female reproductive system.

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2025-05-03 DOI:10.1186/s12880-025-01689-y

Meng Huo, Chunyan Zhang, Ling Li, Jianfeng Xin, Xingpeng Li, Yimeng Zhang, Mingxia Zhang, Ying Sun, Lei Sun, Rengui Wang, Yunlong Yue

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引用次数: 0

Abstract

Objective: To explore the value of non-enhanced magnetic resonance thoracic ductography (NMRTD) combined with MR abdominopelvic scanning in the diagnosis of chylous leakage of the female reproductive system.

Methods: A retrospective analysis was conducted on the multimodal imaging data from non-enhanced magnetic resonance thoracic ductography (NMRTD), direct lymphangiography (DLG), and abdominopelvic magnetic resonance imaging (MRI) for 18 female patients with reproductive system chylous leakage. Among these patients, 7 had vaginal chylous leakage, 10 had vulvar cutaneous chylous leakage, and 1 had both conditions.The rate of successful visualization of the thoracic duct, the consistency of the drainage directions of the outlet of the thoracic duct, and the degree of visualization of each segment of the thoracic duct by NMRTD and DLG were analyzed. A retrospective analysis was performed on the abnormal manifestations of abdominopelvic MR.

Results: NMRTD had a significant advantage over DLG in terms of successful visualization of the thoracic duct (94.4% vs. 66.7%, P = 0.035). The display of the drainage directions in the outlet area of the thoracic duct by the two methods showed excellent consistency (kappa value = 0.815) in 12 patients whose outlet areas were visualized by both methods. The degrees of visualization of the upper, middle, and lower segments of the thoracic duct in the NMRTD group were significantly greater than those in the DLG group (P values were 0.02, 0.00 and 0.00, respectively). All 18 patients (100%) showed dilatation of the lymph vessels in the pelvic cavity and retroperitoneum on abdominopelvic MR and DLG as well as pelvic perineal reflux or leakage on DLG. MR revealed multiple-site abnormalities that could not be detected by DLG, including multiple long T1 and long T2 lesions of the spleen in 8 patients (44.4%), of the subcutaneous in 7 patients (38.9%), of the bone in 6 patients (33.3%), perineal lymphedema in 18 patients (100%), and abdominopelvic effusion in 10 patients (55.6%).

Conclusion: NMRTD combined with abdominopelvic MR has advantages in comprehensively evaluating the thoracic duct and multiple systemic abnormalities in patients with chylous leakage of the female reproductive system.

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非增强磁共振胸导管造影联合磁共振腹腔扫描在女性生殖系统乳糜漏诊断中的应用

目的：探讨非增强型磁共振胸导管造影（NMRTD）联合MR腹腔扫描对女性生殖系统乳糜漏的诊断价值。方法：回顾性分析18例女性生殖系统乳糜漏患者的非增强磁共振胸导管造影（NMRTD）、直接淋巴管造影（DLG）和腹腔磁共振成像（MRI）的多模态影像资料。其中阴道乳糜漏7例，外阴皮肤乳糜漏10例，两者兼有1例。分析NMRTD和DLG对胸导管显像成功率、胸导管出口引流方向的一致性、胸导管各段显像程度。结果：NMRTD在胸导管显像成功率方面优于DLG （94.4% vs 66.7%, P = 0.035）。两种方法显示的胸导管出口区引流方向在12例患者中均表现出极好的一致性（kappa值= 0.815）。NMRTD组胸导管上、中、下段可见程度明显大于DLG组（P值分别为0.02、0.00、0.00）。18例患者（100%）均表现为盆腔及腹膜后淋巴血管扩张，DLG表现为盆腔会阴反流或漏。MR显示DLG无法检测到的多部位异常，包括脾脏多发长T1和长T2病变8例（44.4%），皮下7例（38.9%），骨骼6例（33.3%），会阴淋巴水肿18例（100%），腹腔积液10例（55.6%）。结论：NMRTD联合腹盆MR对女性生殖系统乳糜漏患者的胸导管及多系统异常具有综合评价的优势。

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

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.