Sonographic Assessment of the Terminal Thoracic Duct in Patients with Lymphedema

Gao, Chao; Yang, Meng; Su, Na; Li, Xiongwei; Yang, Elan; Huang, Jiuzuo; Yu, Nanze; Long, Xiao

doi:10.4103/0366-6999.200546

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Attempts to visualize the terminal TD by US vary, with a success rate of between 57% and 100% (Zironi et al, 1995; Seeger et al, 2009; Kochilas et al, 2014; Guevara et al, 2016; Gao et al, 2017; Kunze & Staritz, 2017; Sung et al, 2017). The largest study (Seeger et al, 2009), which included 265 healthy volunteers, reported successful TD visualization in 96% of cases; though contrast‐enhanced US of the TD was used to aid identification.…”

Section: Discussionmentioning

confidence: 99%

The effect of respiration and body position on terminal thoracic duct diameter and the lymphovenous junction: An exploratory ultrasound study

et al. 2021

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The thoracic duct (TD) drains most of the body's lymph back to the venous system via its lymphovenous junction (LVJ), playing a pivotal role in fluid homeostasis, fat absorption and the systemic immune response. The respiratory cycle is thought to assist with lymph flow, but the precise mechanism underpinning terminal TD lymph flow into the central veins is not well understood. The aim of this study was to use ultrasonography (US) to explore the relationship between terminal TD lymph flow, the respiratory cycle, and gravity. The left supraclavicular fossa was scanned in healthy non‐fasted volunteers using high‐resolution (13–5 MHz) US to identify the terminal TD and the presence of a lymphovenous valve (LVV). The TD's internal diameter was measured in relation to respiration (inspiration vs. expiration) and body positioning (supine vs. Trendelenburg). The terminal TD was visualized in 20/33 (61%) healthy volunteers. An LVV was visualized in only 4/20 (20%) cases. The mean terminal TD diameter in the supine position was 1.7 mm (range 0.8–3.1 mm); this increased in full inspiration (mean 1.8 mm, range 0.9–3.2 mm, p < 0.05), and in the Trendelenburg position (mean 1.8 mm, range 1.2–3.1 mm, p < 0.05). The smallest mean terminal TD diameter occurred in full expiration (1.6 mm, range 0.7–3.1 mm, p < 0.05). Respiration and gravity impact the terminal TD diameter. Due to the challenges of visualizing the TD and LVJ, other techniques such as dynamic magnetic resonance imaging will be required to fully understand the factors governing TD lymph flow.

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Section: Discussionmentioning

confidence: 99%

The effect of respiration and body position on terminal thoracic duct diameter and the lymphovenous junction: An exploratory ultrasound study

et al. 2021

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“…Ultrasonography rules out edema caused by venous thrombosis or reflux disease. Furthermore, high resolution ultrasonography helps assess central lymphatic channel, such as thoracic duct, the diameter of which is proven to significantly decrease in lymphedema [32] . We retrospectively analyzed the data of all patients with lymphedema treated in our Medical College Hospital, Department of Lymphedema Treatment Center from September 2015 to January 2017.…”

Section: Othersmentioning

confidence: 99%

Diagnostic workup of lymphedema

Liang¹,

Long²,

Yu³

et al. 2019

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Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality. History, physical and laboratory examinations could help to diagnosis > 90% lymphedema patients. Early stage lymphedema could be challenging to diagnose. The aim of this review is to provide an objective appraisal of current diagnostic methods, such as lymphoscintigraphy, lympho-fluoroscopies, lymphangiography and etc. focusing on their respective advantages and weaknesses, and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.

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Lymphatic drainage dysfunction via narrowing of the lumen of cisterna chyli and thoracic duct after luminal dilation

et al. 2023

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Sonographic Assessment of the Terminal Thoracic Duct in Patients with Lymphedema

Cited by 5 publications

References 14 publications

The effect of respiration and body position on terminal thoracic duct diameter and the lymphovenous junction: An exploratory ultrasound study

The effect of respiration and body position on terminal thoracic duct diameter and the lymphovenous junction: An exploratory ultrasound study

Diagnostic workup of lymphedema

Lymphatic drainage dysfunction via narrowing of the lumen of cisterna chyli and thoracic duct after luminal dilation

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