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Computed Tomography-Guided Access to the Cisterna Chyli: Introduction of a Technique for Direct Lymphangiography to Evaluate and Treat Chylothorax

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Abstract

The purpose of this report is to introduce a technique of direct lymphangiography to enable chylothorax treatment. Using a hybrid computed tomography (CT) and fluoroscopy imaging system, a 21-gauge needle was placed under CT guidance into the cisterna chyli to allow contrast lymphangiography and CT lymphangiography in two patients with presumed postoperative chylothorax. Water-soluble contrast media injection demonstrated the thoracic duct anatomy in both patients. Further successful needle disruption of the cisterna chyli was performed in one patient to interrupt lymph flow and stop the chylous leak, with subsequent resolution of the chylothorax.

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References

  1. Binkert C, Yucel EK, Davison B, Sugarbaker D, Baum R (2005) Percutaneous treatment of high-output chylothorax with embolization or needle disruption technique. J Vasc Interv Radiol 16(9):1257–1262

    PubMed  Google Scholar 

  2. Boffa D, Sands M, Rice T, Murthy S, Mason D, Geisinger M et al (2008) A critical evaluation of a percutaneous diagnostic and treatment strategy for chylothorax after thoracic surgery. Eur J Cardiothorac Surg 33(3):435–439

    Article  PubMed  Google Scholar 

  3. Cope C, Kaiser L (2002) Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. J Vasc Interv Radiol 13(11):1139–1148

    Article  PubMed  Google Scholar 

  4. Cope C, Salem R, Kaiser LR (1999) Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct: Prospective trial. J Vasc Interv Radiol 10(9):1248–1254

    Article  CAS  PubMed  Google Scholar 

  5. Barrett T, Choyke P, Kobayashi H (2006) Imaging of the lymphatic system: new horizons. Contrast Media Mol Imaging 1(6):230–245

    Article  CAS  PubMed  Google Scholar 

  6. Feuerlein S, Kreuzer G, Schmidt S, Muche R, Juchems M, Aschoff A et al (2009) The cisterna chyli: prevalence, characteristics and predisposing factors. Eur Radiol 19(1):73–78

    Article  PubMed  Google Scholar 

  7. Inoue Y, Otake T, Nishikawa J, Sasaki Y (1997) Lymphoscintigraphy using Tc-99m human serum albumin in chylothorax. Clin Nucl Med 22(1):60

    Article  CAS  PubMed  Google Scholar 

  8. Motoyama S, Okuyama M, Saito R, Kitamura M, Ishiyama K, Ogawa J-I (2005) Magnetic resonance imaging for chylothorax after esophagectomy. Jpn J Thorac Cardiovasc Sur 53(8):434–436

    Article  Google Scholar 

  9. Stavngaard T, Mortensen J, Brenoe J, Svendsen LB (2002) Lymphoscintigraphy using technetium-99m human serum albumin in chylothorax. Thorac Cardiovasc Surg 50(4):250–252

    Article  CAS  PubMed  Google Scholar 

  10. Pinto P, Sirlin C, Andrade-Barreto O, Brown M, Mindelzun R, Mattrey R (2004) Cisterna chyli at routine abdominal MR imaging: a normal anatomic structure in the retrocrural space. Radiographics 24(3):809–817

    Article  PubMed  Google Scholar 

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Acknowledgment

Stephen B. Solomon is consultant to and a grant recipient from GE Healthcare, Milwaukee, WI.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Helmut Schoellnast, Majid Maybody, George I. Getrajdman & Stephen B. Solomon

  2. Department of Radiology, Medical University of Graz, Auenbruggerplatz 9, 8036, Graz, Austria

    Helmut Schoellnast

  3. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Manjit S. Bains & David J. Finley

Authors
  1. Helmut Schoellnast
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  2. Majid Maybody
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  3. George I. Getrajdman
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  4. Manjit S. Bains
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  5. David J. Finley
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  6. Stephen B. Solomon
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Correspondence to Stephen B. Solomon.

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Schoellnast, H., Maybody, M., Getrajdman, G.I. et al. Computed Tomography-Guided Access to the Cisterna Chyli: Introduction of a Technique for Direct Lymphangiography to Evaluate and Treat Chylothorax. Cardiovasc Intervent Radiol 34 (Suppl 2), 240–244 (2011). https://doi.org/10.1007/s00270-010-9851-9

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  • DOI: https://doi.org/10.1007/s00270-010-9851-9

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