Therapeutic lymphangiography
Therapeutic lymphangiography
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治疗性淋巴管造影
DOI：
10.11407/ivr.34.177
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
今井 裕
中科院分区：
文献类型：
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作者：
松本 知博;長谷部 光泉;富田 康介;亀井 俊佑;橋田 和靖;須田 慧;山本 章太;吉松 梨香;山上 卓士;今井 裕
由于体液、血浆蛋白、脂肪和免疫调节性淋巴细胞的大量丢失，以及严重营养不良、低钠血症、酸中毒、低钙血症和易感染的临床特征，乳糜失入胸/腹膜腔可导致严重危及生命的后果。我们报道淋巴管造影术不仅对诊断有效，而且对各种乳糜漏也有治疗作用。从那时起，关于淋巴漏的治疗性淋巴管造影术和术后乳糜胸的胸腔导管栓塞术(TDE)等淋巴干预措施的报道越来越多。然而，术后淋巴漏仍然是一个具有挑战性的临床问题，食道手术后的死亡率很高。尽管存在这个临床问题，但到目前为止还没有开发出淋巴干预的动物模型。有一些关于猪淋巴管造影术和TDE模型的报道。的确，猪的模型模仿了人类的淋巴学。然而，猪模型的维护成本更高，更难操作。猪的实验研究需要现代化的基础设施和训练有素的人员。另一方面，兔子价格低廉，易于在实验室环境中管理，并且拥有与人类相似的器官系统。对于淋巴干预和未来的淋巴成像，应该阐明兔模型的详细淋巴解剖学特征。在这里，我们将介绍各种淋巴漏的治疗性淋巴管造影术，以及淋巴管造影术后多层螺旋CT上淋巴管造影术和淋巴系统可见性在兔模型临床前淋巴干预中的可行性。
Loss of chyle into the thoracic/peritoneal cavity can lead to serious life-threatening conse-quences because of the significant loss of fluid, plasma protein, fats and immunoregulatory lymphocytes, and clinical features of severe malnutrition, hyponatraemia, acidosis, hy-pocalcaemia and susceptibility to infection. We reported that lymphangiography was effective not only for diagnosis but also as treatment for various chyle leakages. Since then, reports on lymphatic interventions including therapeutic lymphangiography for lymphatic leaks and thoracic duct embolization (TDE) for postoperative chylothorax have been increasing in number. However, postoperative lymphatic leakage remains a challenging clinical problem with high mortality in post esophageal surgery. Despite this clinical problem, an animal model for lymphatic interventions has not been developed so far. There have been a few reports on a swine model of lymphangiography and TDE. It is true that a swine model mimics the human lym-phatics. However, a swine model has higher maintenance costs and is harder to handle. Spe-cialized infrastructure and trained personnel are needed for experimental study in swine. On the other hand, rabbits are inexpensive, easy to manage in a laboratory setting and have an organ system like that of humans. For lymphatic interventions and future lymphatic imaging, detailed lymphatic anatomical features in a rabbit model should be elucidated. Here, we would like to introduce therapeutic lymphangiography for various lymphatic leaks, and feasibility of lym-phangiography and the visibility of the lymphatic system on post-lymphangiographic multi-detector row CT for preclinical lymphatic interventions in a rabbit model.