Thoracic duct and cisterna chyli: evaluation with multidetector row CT

Abstract

Objectives: The aim of this study was to evaluate the normal anatomy of the thoracic duct and cisterna chyli obtained by axial and multiplanar reformation (MPR) images of 1 mm slice thickness using multidetector row CT (MDCT). Methods: We evaluated the ability of MDCT to examine the normal anatomy of the thoracic duct and cisterna chyli. The axial and coronal images of thoracoabdominal MDCT images obtained in 50 patients (20 females and 30 males; mean age, 63.5 years; range, 32-81 years) were reviewed between January and October 2005. We excluded patients with malignant neoplasms, inflammation or vascular diseases (e.g. aortic aneurysm, aortic dissection) and those with a history of thoracoabdominal surgery. The thoracic duct was divided into three anatomical sections: the upper, middle and lower. We evaluated the degree of visualisation and the maximum size of the thoracic duct. We also evaluated the degree of visualisation, maximum size, configuration and location of the cisterna chyli. Results: Visualisation of the thoracic duct and cisterna chyli was almost 100% on axial and coronal images. The lower section of the thoracic duct was most clearly visualised among the three sections. There was little difference in the maximum size of the thoracic duct among the three sections. The cisterna chyli was most frequently located at the Th12 or L1 level, and the most common type was the ''straight thin tube type''. Conclusion: Axial and MPR images of 1 mm slice thickness using MDCT can clearly depict the thoracic duct and cisterna chyli.

A radio‐anatomical correlation study of the cisterna chyli

“…; Kiyonaga et al. ). Furthermore, the appearance of the CC can mimic an enlarged retrocrural lymph node on abdominal CT and correct identification is quite difficult (Gollub & Castellino, ; Pinto et al.…”

“…), unless it is specifically studied on thin‐slice, multiplanar reconstructions (Kiyonaga et al. ). The CC is also difficult to differentiate from vascular structures or retrocrural lymph nodes on abdominal ultrasound (Tamsel et al.…”

“…; Kiyonaga et al. ), and ultrasound, conventional CT and MRI examinations are not useful in practice (Akcali et al. ).…”

“…Although it involves invasive procedures and patient discomfort (Arriv e et al 2007), lymphangiography is a valuable tool for the detection of 64-78% of lymphatic leakages (Lee et al 2014). The normal CC is rarely visible on a routine CT-scan, even with intravenous contrast administration (1.7-16.1% of abdominal CT-scans) (Smith & Grigoropoulos, 2002;Feuerlein et al 2009), probably because lymphatic capillaries are very thin and have very low contrast enhancement (Feuerlein et al 2009;Kiyonaga et al 2012). Furthermore, the appearance of the CC can mimic an enlarged retrocrural lymph node on abdominal CT and correct identification is quite difficult (Gollub & Castellino, 1996;Pinto et al 2004;Feuerlein et al 2009), unless it is specifically studied on thin-slice, multiplanar reconstructions (Kiyonaga et al 2012).…”

“…The normal CC is rarely visible on a routine CT-scan, even with intravenous contrast administration (1.7-16.1% of abdominal CT-scans) (Smith & Grigoropoulos, 2002;Feuerlein et al 2009), probably because lymphatic capillaries are very thin and have very low contrast enhancement (Feuerlein et al 2009;Kiyonaga et al 2012). Furthermore, the appearance of the CC can mimic an enlarged retrocrural lymph node on abdominal CT and correct identification is quite difficult (Gollub & Castellino, 1996;Pinto et al 2004;Feuerlein et al 2009), unless it is specifically studied on thin-slice, multiplanar reconstructions (Kiyonaga et al 2012). The CC is also difficult to differentiate from vascular structures or retrocrural lymph nodes on abdominal ultrasound (Tamsel et al 2006;Wachsberg, 2006;Etienne et al 2013).…”