3. 0 T MR 檢測胸導管的臨床意義
于德新 李傳福 張曉明 修建軍 王茜 孟祥水
【摘要】 目的 利用3. 0 T MR 重T2WI 技術對成人胸導管進行成像, 并探討病變對其形態的影
響。方法 對139 例患者進行胸腹部三維MR 胰膽管成像( MR cholangiopancreatography, MRCP) , 選
取達到測量要求的97 例, 并分為正常對照組、門靜脈高壓組和膽管擴張組。觀察乳糜池和胸導管的
形態、位置、淋巴干、淋巴管等情況, 并對其上下徑、左右徑和前后徑等進行測量, 探討以上測量數值在
各組之間的差異。結果 乳糜池的形態變異較大, 73. 20% ( 71 例) 為管狀或梭形, 84. 54% ( 82 例) 位
于第1、2 腰椎水平之間, 74. 23%( 72 例) 位于椎體中央的前方。乳糜池平均的長徑、前后徑和左右徑
分別為( 26. 94 ±10. 24) 、( 4. 86 ±2. 01) 和( 4. 96 ±1. 89) mm。88 例( 90. 72%) 患者的胸導管從乳糜
池上行后在第8 ～11 胸椎水平逐漸轉向椎體的左側再繼續上行。在正常對照組、門靜脈高壓組和膽
管擴張組, 胸導管的左右徑分別為( 3. 58 ±0. 95) 、( 4. 83 ±1. 33) 和( 3. 65 ±1. 57) mm, 其差異存在統
計學意義( F = 5. 638, P = 0. 005) , 其他數值在3 組之間差異無統計學意義( P > 0. 05) 。結論 利用
3. 0 T 重T2WI MR 技術可以對胸導管進行有效的顯示和測量, 門靜脈高壓影響胸導管的寬度。
【關鍵詞】 磁共振成像; 胸導管
Detecta bility and mor phological featur es of thor acic duct a t 3. 0 T MR YU De-xin, LI Chuan-fu,
ZHANG Xiao-ming, XIU J ian-jun, WANG Qian, MENG Xia ng-shui. Department of Ima ging Center, Qilu
Hospital of Sha ndong University, J inan 250012, China
Corresponding author: LI Chuan-fu
【Abstra ct 】 Objective To detect the position, configuration, dimensions of the thoracic duct on
heavily T2 -weighted images and to probe the relationship of the dimensions of the thoracic duct and cisterna
chyli between disorders and control groups. Methods Maximum intensity projection ( MIP ) images
originally obtained from three-dimensional MR cholangiopancreatography in 139 patients were reviewed by
two observers to evaluate the thoracic duct, and 42 cases were excluded because of poor reconstructional
images. The location, configuration, lymphatic trunks and small lymphatic channels of cisterna chili were
reviewed, and the dimensions of the thoracic duct and the cisterna chyli were measured and analyzed
statistically among the groups of control group, portal hypertension group and choledochus obstruction group
using one-way analysis of variance test. Results The most common configuration of the cisterna chyli was
tubular or saccular ( 73. 20% ) , 84. 54% of them located at the level of L1, 2 , and 74. 23% anterior to the
midline of the vertebral body. The mean longitudinal, anteroposterior and transverse diameters of the cisterna
chyli were ( 26. 94 ±10. 24 ) mm, ( 4. 86 ±2. 01 ) mm, and( 4. 96 ±1. 89 ) mm respectively, The transverse
diameters of the thoracic duct of contrel group, portal hypertension group and chaledochus obstruction group
were ( 3. 58 ±0. 95 ) vs ( 4. 83 ±1. 33 ) and ( 3. 65 ±1. 57 ) mm, respetively and there was statistical
difference between them( F = 5. 638, P = 0. 005) . 90. 72% of thoracic ducts turned left at the level of T8—
10 . There was a significant difference in the transverse diameters of thoracic duct between the control and
risk groups ( F = 5. 638, P = 0. 005 ) , but the differences in other parameters were not found in this study
( P > 0. 05) . Conclusion Thoracic duct and cisterna chyli can be shown well on heavily T2 -weighted
images at 3. 0 T MR, and the portal hypertension may influence the dimension of thoracic duct.
【Key wor ds】 Magnetic resonance imaging; Thoracic duct3. 0 T MR 檢測胸導管的臨床意義--胸部.rar