Computed tomography-guided access to the cisterna chyli: introduction of a technique for direct lymphangiography to evaluate and treat chylothorax.
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.
Schoellnast
Helmut
H
Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Maybody
Majid
M
Getrajdman
George I
GI
Bains
Manjit S
MS
Finley
David J
DJ
Solomon
Stephen B
SB
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D001706:Biopsy; D002916:Chylothorax / Q000000981:diagnostic imaging* / Q000628:therapy*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008220:Lymphography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008481:Mediastinoscopy; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods*; D013897:Thoracic Duct / Q000000981:diagnostic imaging*; D020775:Thoracic Surgery, Video-Assisted; D036542:Tomography, Spiral Computed / Q000379:methods*
D003287:Contrast Media