Abdominal Confluence of Lymph Trunks: Detectability and Morphology on Heavily T2-Weighted Images

Erden, Ayşe; Fítöz, Suat; Yağmurlu, Banu; Erden, İlhan

doi:10.2214/ajr.184.1.01840035

Cited by 47 publications

(49 citation statements)

References 18 publications

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“…Few previous studies have reported the imaging appearance of CC [15,16]; the frequency of seeing the CC on lymphangiography ranged from 30% to 53% [4], but only 1.7% on CT [17] On MRI, Erden et al [18] detected CC in 96% of patients on heavily T2-weighted images. Unlike these investigators, we used a threshold diameter of 2 mm for identifying CC because of potential variability in identifying structures smaller than a pixel.…”

Section: Discussionmentioning

confidence: 99%

Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging

et al. 2008

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“…For example, considering that the classical location of the CC (according to anatomical and surgical texts) occurs at L1-L2, a more superior location has a greater potential to be misdiagnosed as a pathologic lesion of the posterior mediastinum. Several radiological studies demonstrating the recent advancement of imaging techniques have proved the importance of accurate anatomical knowledge of the TD and CC (Erden et al, 2005). For instance, the radiographic appearance of mediastinal nodes has been associated with TD anatomic variations (Cha and Sirijintakarn, 1976), and the CC has been shown to mimic the appearance of an enlarged retrocrural lymph node (Gollub and Castellino, 1996).…”

Section: Discussionmentioning

confidence: 99%

Cisterna chyli: A detailed anatomic investigation

et al. 2007

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With recent laparoscopic advancements in retroperitoneal and thoracic surgical procedures, familiarity with major lymphatic structures, such as including the cisterna chyli (CC) and thoracic duct (TD), has proven beneficial in avoiding misdiagnosis and iatrogenic intraoperative injury. In this light, the aim of our study was to explore and delineate the topography of the CC, classify the different patterns of lymphatic tributaries, and categorize its varying location with respect to the vertebral bodies. The anatomy of the CC was examined in 120 adult human cadavers. The CC was found in 83.3% of the specimens and both the tributaries of the CC and the location, with respect to vertebral level, demonstrated wide variation. The results were classified into four types. The most common tributary configuration (type I), found in 45% specimens, was a single CC formed by the union of the left lumbar trunk (LT) and the intestinal trunk (IT). In 30% the CC was formed where the IT opened into the TD and the right lumbar trunk (RT), LT, retroaortic nodes (RN) and branches from the intercostal lymphatics (IL) joined variably (type II). In 20% the CC was formed by the junction of the RT and IT (type III), while in 5% there was a variable confluence pattern of lymphatic trunks that could not be classified (type IV). The CC was located at L1-L2 (type A) in 63%, T12-L1 (type B) in 21%, T11-T12 (type C) in 8%, T10-11 (type D) in 5%, and T9-10 (Type E) in 3%, of the specimens. The CC was found in the retrocrural space and, in 75% of the cases, to the right of the abdominal aorta. We hope that the data supplied by this study will provide useful information in the future to anatomists, radiologists and surgeons alike.

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“…As a conclusion, anatomic variations of the thoracic duct are numerous and must be considered to avoid complications when doing surgery. nance imaging [2,11]. These methods are not useful in practice.…”

Section: Omer Akcali Amac Kiray Ipek Ergur Suleyman Tetik Emin Alicimentioning

confidence: 99%

Thoracic duct variations may complicate the anterior spine procedures

et al. 2006

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IntroductionThe thoracic duct is the primary lymphatic vessel and it collects the lymphatic fluid from all the minor lymphatic vessels. Its distal dilated origin is known as cisterna chyli and it is usually located on the anterior surface of the first or second lumbar vertebra. It extends superiorly and usually drains into the left subclavian vein [3,7]. Thoracic duct injury and chylous leakage is a rare complication in spine surgery. However, lymphatic injury after spinal operations [10,12,17] Abstract The aim of this study is to localize and document the anatomic features of the thoracic duct and its tributaries with special emphasis on the spinal surgery point of view. The thoracic ducts were dissected from nine formaldehyde-preserved male cadavers. The drainage patterns, diameter of the thoracic duct in upper, middle and lower thoracic segments, localization of main tributaries and morphologic features of cisterna chyli were determined. The thoracic duct was detected in all cadavers. The main tributaries were concentrated at upper thoracic (between third and fifth thoracic vertebrae) and lower thoracic segments (below the level of ninth thoracic vertebra) at the right side. However, the main lymphatic tributaries were drained into the thoracic duct only in the lower thoracic area (below the level of the tenth thoracic vertebra) at the left side. Two major anatomic variations were detected in the thoracic duct. In the first case, there were two different lymphatic drainage systems. In the second case, the thoracic duct was found as bifid at two different levels. In formaldehyde preservation, the dimensions of the soft tissues may change. For that reason, the dimensions were not discussed and they may not be a guide in surgery. Additionally, our study group is quite small. Larger series may be needed to define the anatomic variations. As a conclusion, anatomic variations of the thoracic duct are numerous and must be considered to avoid complications when doing surgery.

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Abdominal Confluence of Lymph Trunks: Detectability and Morphology on Heavily T2-Weighted Images

Cited by 47 publications

References 18 publications

Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging

Dilated cisternae chyli: a sign of uncompensated cirrhosis at MR imaging

Cisterna chyli: A detailed anatomic investigation

Thoracic duct variations may complicate the anterior spine procedures

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