Computed Tomographic Characteristics of the Cisterna Chyli in Dogs

Abstract

Previous lymphangiographic studies have investigated the use of computed tomography (CT) for characterizing the thoracic duct and its tributaries in dogs. However, there is limited published information on the appearance of the canine cisterna chyli using CT. The objective of this retrospective study was to describe the features of the canine cisterna chyli in pre- and post-contrast abdominal CT studies. The presence, location, shape, maximum width, size compared with the aortic diameter (Ao:cisterna chyli ratio) and mean attenuation of the cisterna chyli were recorded from archived abdominal CT scans of 30 dogs. Breed, age, sex and neutering status were also noted. A cisterna chyli was identified in 26 of the dogs (87%). In 22 cases a cisterna chyli could be reliably identified prior to intravenous contrast administration and in all 26 cases in postcontrast images. The cisterna chyli was most commonly located right dorsolateral to the abdominal aorta between L1 and L4. Shape varied on transverse images from crescent-like to globular and maximum diameters ranged from 5 to 9 mm. The Ao:cisterna chyli ratio varied between 0.29 and 0.71 (mean value-males: 0.32; females: 0.38). On pre-contrast images the mean Hounsfield units were 21.3HU (range: -3.8 to 64.25). Mild enhancement of the cisterna chyli post-contrast was observed in 24 dogs (80%). Findings supported the use of pre- and post-contrast abdominal CT as a non-invasive method for assessing qualitative and quantitative characteristics of the canine cisterna chyli.

Hybrid single‐port laparoscopic cisterna chyli ablation for the adjunct treatment of chylothorax disease in dogs

“…The SILS SPD was the only laparoscopic port used in all cases. The cranial abdomen was visualized laparoscopically, and the area cranial to the kidney was inspected . In all 14 cases, the CC was identified and ablated.…”

“…Cisterna chyli ablation is facilitated by the use of lymphangiography to aid in identification of the CC intraoperatively. Accurate identification and precise dissection of the CC is crucial because of the close proximity of vital structures . This was emphasized by a previous report of laparoscopic CC using a transdiaphragmatic approach in which laceration of the aortic hiatus and aorta was reported …”

“…Cisterna chyli ablation is used as an adjunct procedure to TDL. The cisterna chyli (CC) represents a collection reservoir of lymph where the mesenteric, lumbar, and hepatic lymphatics join . Cisterna chyli ablation creates a large opening in this reservoir, and chyle that would normally travel to the thoracic duct (TD) system is redirected into the abdomen, reducing pressure in the lymphatic system caudal to the site of TDL .…”

Anatomic and volumetric characterization of the cisterna chyli using CT lymphangiography and computer‐assisted design software in dogs with idiopathic chylothorax

“…Attenuation values were determined by measuring the HU using a region of interest (ROI) at three separate locations from different transverse slices within the CC and then calculating the mean. The height and maximum width compared with the aortic diameter (Ao:CC ratio) were recorded from transverse CTLa images 15 . The length was obtained using the sagittal reconstruction at the same slice where the transverse slice determined maximum width.…”

“…Despite its significance, the anatomy of the CC can be challenging to assess in the clinical setting 14 . Previous studies have investigated and characterized the anatomy of the CC in dogs using contrast enhanced CT, MRI, and abdominal ultrasonography 15–17 . Computed tomography lymphangiography (CTLa) is currently considered the gold standard for evaluating the lymphatic system in dogs with chylothorax 18–21 ; however, based on our review of the literature, there are no reports evaluating the use of CTLa to characterize the CC in dogs with naturally occurring lymphatic disease such as idiopathic chylothorax.…”