Cisterna chyli in patients with malignancy--influence of cardiovascular disease on the prevalence of the cisterna.
The purpose of this study was to investigate the potential correlation between the presence and size of the cisterna chyli (CC) on computed tomography (CT) and the presence of cardiovascular disease.


METHODS
Out of a 3000-patient cohort 2599 patients who received a CT examination of the chest and/or abdomen with measurable inferior vena cava and azygos vein were included in this retrospective study. To assess the presence of cardiovascular disease the following parameters were recorded from the PACS or clinical information system: diameter of vena cava and azygos vein, presence of ascitis, serum creatinine, history of congestive heart failure, coronary artery disease or arterial hypertension and medication (diuretics, beta-blocker). In addition the volume of the CC and the presence or absence of malignant disease were recorded. Mean values (vessel diameters, creatinine) or percentages were calculated and compared for the groups with (n=416) and without (n=2183) a cisterna. Multivariate logistic regression analysis was performed for all parameters to identify the potential association with the presence and size of a cisterna. In addition the simultaneous influence of the parameter malignancy, cardiovascular disease and age on presence and size of the CC was analyzed in a logistic regression model.


RESULTS
The presence or absence of a CC was not associated with any of the measured parameter. Regarding the size of the CC, there was a positive correlation with the diameter of the azygos vein, the presence of ascitis and diuretic medication. The influences of malignancy, elevated central venous pressure and age on the development of a CC proved to be highly significant but could not be separated or quantified.


CONCLUSIONS
The volume of the cisterna chyli is influenced by pathologic states with an increased central venous pressure, while the presence or absence of the cisterna seems to be independent of those factors.
Feuerlein
Sebastian
S
Department of Diagnostic and Interventional Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany. sfeuerlein@yahoo.com
Stolz
Jochen
J
Muche
Rainer
R
Hetzel
Martin
M
Klass
Oliver
O
Brambs
Hans-Juergen
HJ
Pauls
Sandra
S
D000368:Aged; D001401:Azygos Vein / Q000000981:diagnostic imaging; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D013897:Thoracic Duct / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol