张丽,郝昆,文哲,陈钊,康磊,童冠圣.99Tcm-右旋糖酐淋巴显像诊断乳糜胸[J].中国医学影像技术,2023,39(1):48~51
99Tcm-右旋糖酐淋巴显像诊断乳糜胸
99Tcm-dextran lymphoscintigraphy for diagnosis of chylothorax
投稿时间:2022-08-01  修订日期:2022-10-20
DOI:10.13929/j.issn.1003-3289.2023.01.010
中文关键词:  乳糜胸|淋巴造影术|放射性核素显像
英文关键词:chylothorax|lymphography|radionuclide imaging
基金项目:
作者单位E-mail
张丽 首都医科大学附属北京世纪坛医院核医学科, 北京 100038  
郝昆 首都医科大学附属北京世纪坛医院淋巴外科, 北京 100038  
文哲 首都医科大学附属北京世纪坛医院核医学科, 北京 100038  
陈钊 北京大学第一医院核医学科, 北京 100034  
康磊 北京大学第一医院核医学科, 北京 100034  
童冠圣 首都医科大学附属北京世纪坛医院核医学科, 北京 100038 tgseng@163.com 
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中文摘要:
      目的 探讨99Tcm-右旋糖酐(DX)淋巴显像诊断乳糜胸的价值。方法 回顾性分析95例实验室检查证实单侧胸腔积液甘油三酯含量高于1.24 mmol/L而临床诊断乳糜胸患者的99Tcm-DX淋巴显像资料,观察双下肢淋巴引流、胸导管及静脉角区放射性分布及患侧胸腔有无异常放射性分布。结果 95例中,43例(43/95,45.26%)下肢淋巴回流正常,36例(36/95,37.89%)淋巴回流缓慢,16例(16/95,16.84%)肢体淋巴水肿;41例(41/95,43.16%)胸导管出口梗阻,表现为左静脉角持续或增宽显影、显像剂异常反流或双侧静脉角显影;89例(89/95,93.68%)患侧胸腔内放射性异常增高,其中2例(2/95,2.11%)见可疑乳糜漏出点,6例(6/95,6.32%)胸腔内未见明显异常放射性分布。结论 99Tcm-DX淋巴显像有助于诊断乳糜胸。
英文摘要:
      Objective To explore the value of 99Tcm-dextran (DX) lymphoscintigraphy for diagnosis of chylothorax. Methods Data of 99Tcm-DX lymphoscintigraphy of 95 patients with diagnosed clinically chylothorax since laboratory examination confirmed unilateral pleural effusion with triglyceride content higher than 1.24 mmol/L were retrospectively analyzed. Lower limb lymphatic reflux, radiation distribution in thoracic duct and venous angle area and the affected chest were observed. Results Among 95 cases, 43 (43/95, 45.26%) were found with normal lymphatic reflux in lower extremity, 36 (36/95, 37.89%) with slow lymphatic reflux and 16 (16/95, 16.84%) with lymphedema. Obstruction of thoracic duct outlet was found in 41 cases (41/95, 43.16%), manifested as continuous or widening left venous angle imaging, abnormal reflux of imaging agent or bilateral venous angle imaging. Abnormal radioactivity increase in the affected chest were detected in 89 cases (89/95, 93.68%) including 2 cases (2/95, 2.11%) with suspicious chylous leakage points, while 6 cases (6/95, 6.32%) were found without obvious abnormal radioactivity distribution. Conclusion 99Tcm-DX lymphoscintigraphy was helpful for diagnosis of chylothorax.
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