Gastrointestinal

European Radiology

, Volume 19, Issue 1, pp 73-78

First online:

The cisterna chyli: prevalence, characteristics and predisposing factors

  • Sebastian FeuerleinAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm Email author 
  • , Georg KreuzerAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm
  • , Stefan A. SchmidtAffiliated withDepartment of Internal Medicine, Karl-Olga-Hospital
  • , Rainer MucheAffiliated withInstitute of Biometry, University of Ulm
  • , Markus S. JuchemsAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm
  • , Andrik J. AschoffAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm
  • , Hans-Juergen BrambsAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm
  • , Sandra PaulsAffiliated withDepartment of Diagnostic and Interventional Radiology, University of Ulm

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Abstract

The purpose of this study was to determine the prevalence and characteristics of the cisterna chyli (CC) in a large 3,000-patient cohort and to identify potential predisposing factors for the development of a CC. Three thousand consecutive contrast-enhanced CT examinations (1,261 women, 1,739 men, mean age 61.0 years) of the chest and/or abdomen were included in this retrospective study. Imaging characteristics of the CC (size, attenuation, location) were documented as well as clinical information (malignant disease, pattern of metastasis). A CC was found in 16.1% of the patients with an average volume of 302 µl. The mean attenuation was 4.8 Hounsfield units (HU). Twenty percent of the CC showed CT densities of 15 HU and higher. Patients with malignancies showed a significantly (p < 0.001) higher prevalence of CC (340/1,757, 19.4%) than patients with benign conditions (144/1,243, 11.6%). Especially the finding of a large CC (>1,000 µl) represents an elevated relative risk for malignancy of 1.7 (p = 0.0017). We found a significant association between malignant disease and the presence and size of a cisterna chyli. Identifying the continuity between the CC and the thoracic duct is a safer method to distinguish a CC from retrocrural lymph nodes than near-water CT attenuation alone.

Keywords

Cisterna chyli Lymphatic system Computed tomography