Intranodal Lymphangiogram: Technical Aspects and Findings
Intranodal Lymphangiogram: Technical Aspects and Findings
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DOI：
10.1007/s00270-014-0888-z
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发表时间：
2014-12-01
影响因子：
2.9
通讯作者：
Tanigawa, Noboru
中科院分区：
文献类型：
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作者：
Kariya, Shuji;Komemushi, Atsushi;Tanigawa, Noboru
为了报告结内淋巴管造影(INL)的技术结果和影像表现，我们研究了4例食道癌手术后尽管保守治疗但仍有持续性乳糜漏的患者(3男，1女)。年龄61~74岁，平均68岁。腹股沟或股淋巴结在超声引导下用一根60毫米长的23号针进行穿刺术。如透视下针头注射的碘油呈颗粒状结节，则继续手动注射，注射速度为1mL/3min。如果在淋巴管造影上可发现乳糜池，则在透视下经腹部穿刺针，行胸导管栓塞术。所有患者INL均成功。所有4例患者均证实股骨或盆腔区域的淋巴静脉吻合术。在一例中，不同的同侧淋巴结被刺穿，因为发生了大量的碘化油通过淋巴管-静脉吻合口流入静脉。4例患者中有3例导管插管和栓塞术成功。在失败的手术中，乳糜池无法显示，无法穿刺术。所有患者的INL均获得成功。所有患者的股骨或盆腔区域的淋巴管静脉吻合术中，碘化油均漏入静脉。
To report the technical results and imaging findings of intranodal lymphangiogram (INL).we studied four patients (three men, one woman) who had persistent chylous leakage despite conservative treatment after esophageal cancer surgery. Their mean age was 68 years (range 61-74 years). The inguinal or femoral lymph node was punctured under ultrasound guidance using a 60-mm-long, 23-gauge needle. If the lipiodol injected via the needle showed granular nodules on fluoroscopy, lipiodol injection was continued manually at a rate of 1 mL/3 min for INL. If the cisterna chyli was detectable on the lymphangiogram, it was punctured percutaneously via the abdomen by a needle under fluoroscopy, and thoracic duct embolization was performed.INL was successful in all patients. Lymphaticovenous anastomoses at the femoral or pelvic region were confirmed in all four patients. In one case, a different ipsilateral lymph node was punctured because major flow of lipiodol into the veins through a lymphaticovenous anastomosis occurred. Catheter cannulation and embolization were successful for three of the four patients. In unsuccessful procedures, the cisterna chyli was not visualized, and puncture was not possible.INL succeeded in all patients. Lipiodol leaked into the vein through a lymphaticovenous anastomosis at the femoral or pelvic region in all patients.