Diagnostic value of combined CT lymphangiography and 99Tcm-DX lymphoscintigraphy in primary chylopericardium.

Objective: To investigate the diagnostic value of combined ⁹⁹Tc^m-DX lymphoscintigraphy and CT lymphangiography (CTL) in primary chylopericardium.

Methods: Fifty-five patients diagnosed with primary chylopericardium clinically were retrospectively analyzed. ⁹⁹Tc^m-DX lymphoscintigraphy and CTL were performed in all patients. Primary chylopericardium was classified into three types, according to the ⁹⁹Tc^m-DX lymphoscintigraphy results. The evaluation indexes of CTL include: (1) abnormal contrast distribution in the neck, (2) abnormal contrast distribution in the chest, (3) dilated thoracic duct was defined as when the widest diameter of thoracic duct was > 3 mm, (4) abnormal contrast distribution in abdominal. CTL characteristics were analyzed between different groups, and P < 0.05 was considered a statistically significant difference.

Results: Primary chylopericardium showed 12 patients with type I, 14 patients with type II, and 22 patients with type III. The incidence of abnormal contrast distribution in the posterior mediastinum was greater in type I than type III (P = 0.003). The incidence of abnormal contrast distribution in the pericardial and aortopulmonary windows, type I was greater than type III (P = 0.008). And the incidence of abnormal distribution of contrast agent in the bilateral cervical or subclavian region was greater in type II than type III (P = 0.002).

Conclusion: The combined application of the ⁹⁹Tc^m-DX lymphoscintigraphy and CTL is of great value for the localized and qualitative diagnosis of primary chylopericardium and explore the pathogenesis of lesions.