Cisterna chyli in autosomal dominant polycystic kidney disease.
OBJECTIVE
After observing prominent cisterna chyli in several patients with autosomal dominant polycystic kidney disease (ADPKD), we investigated the potential association of cistern chyli enlargement with ADPKD.


METHODS
Retrospective, cross-sectional analysis of abdominal and pelvic MRI at 1.5 Tesla (T) in 70 ADPKD patients (male 44.3%, 20-83 years, median = 53 years) were compared with 70 age and gender matched control subjects without ADPKD, cirrhosis, or cholestasis. Cisterna chyli diameter was measured on axial single shot fast spin echo (SSFSE) images at the level of T12-L2 and evaluated by multivariable regression models with covariates including estimated glomerular filtration rate (eGFR), total kidney volume (TKV), renal cyst fraction (cyst volume/kidney volume), and liver volume.


RESULTS
Subjects with ADPKD had larger median cisterna chyli diameter compared with those without ADPKD (6.1 mm versus 3.4 mm, P < 0.0001). The prevalence of cisterna chyli enlargement more than the median (3.4 mm), was greater in ADPKD than in controls (99% versus 51%, P < 0.0001). On univariate analysis, cisterna chyli diameter was inversely correlated with eGFR (r = -0.41; P < 0.0001) and directly correlated with TKV (r = 0.57; P < 0.0001), total renal cyst fraction (r = 0.61; P < 0.001), and liver volume (r = 0.17; P = 0.040). Multivariable linear regression modeling found a significant association of cisterna chyli diameter with ADPKD diagnosis (B = 2.14; 95% confidence interval [CI]: 0.05-4.23; P = 0.04). Logistic regression analysis confirmed the association of ADPKD with an enlarged cisterna chyli diameter (odds ratio = 68.4; 95%CI: 8.9-524, P < 0.0001).


CONCLUSIONS
Enlarged cisterna chyli is highly prevalent in ADPKD patients but not in age and gender-matched controls.
Department of Radiology, Weill Cornell Medical Center, New York, New York, USA.
Nanda Deepa
ND
Thimmappa
Jon D
JD
Blumenfeld
Michelle Ann C
MA
Cerilles
Allison
A
Dunning
Stephanie L
SL
Donahue
Warren O
WO
Bobb
Hong Lei
HL
Zhang
Martin R
MR
Prince
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016891:Polycystic Kidney, Autosomal Dominant / Q000473:pathology*; D012189:Retrospective Studies; D013897:Thoracic Duct / Q000473:pathology*; D055815:Young Adult
ADPKD; MRI; cisterna chyli; lymphatics; renal cyst