CAJ | 학술논문

目的探讨直接淋巴管造影术对原发性乳糜尿的诊断作用.方法经单侧足背淋巴管注入碘化油,使用Innova 2100-IQ数字平板血管造影系统,分时段动态连续采集图像观察淋巴系统显影情况.结果 25例患者行直接淋巴管造影术均显示一侧(18例)或双侧(7例)肾脏造影剂反流；21例伴随腹膜后淋巴管扩张、迂曲,13例造影剂向盆腔及(或)对侧骶髂部反流；22例胸导管颈段末段(18例)或颈段全程(4例)狭窄,胸段、腹段增粗扩张,5例胸导管末端未见造影剂入血,17例可见少量造影剂入血；1例胸导管颈段、胸段未见显影,2例胸导管颈段及部分胸段纤细.结论直接淋巴管造影术可动态观察乳糜(淋巴液)的回流改变,能够清晰显示原发性乳糜尿肾区乳糜反流的位置、病变范围、程度.在原发性乳糜尿的成因中胸导管颈段梗阻起重要作用.
목적 탐토직접림파관조영술대원발성유미뇨적진단작용.방법 경단측족배림파관주입전화유,사용Innova 2100-IQ수자평판혈관조영계통,분시단동태련속채집도상관찰림파계통현영정황.결과 25례환자행직접림파관조영술균현시일측(18례)혹쌍측(7례)신장조영제반류；21례반수복막후림파관확장、우곡,13례조영제향분강급(혹)대측저가부반류；22례흉도관경단말단(18례)혹경단전정(4례)협착,흉단、복단증조확장,5례흉도관말단미견조영제입혈,17례가견소량조영제입혈；1례흉도관경단、흉단미견현영,2례흉도관경단급부분흉단섬세.결론 직접림파관조영술가동태관찰유미(림파액)적회류개변,능구청석현시원발성유미뇨신구유미반류적위치、병변범위、정도.재원발성유미뇨적성인중흉도관경단경조기중요작용.
Objective To discuss the role of direct lymphangiography in the diagnosis of primary chyluria.Methods Iodized oil was infused into lymphatic vessel of unilateral foot in 25 cases.The condition of lymphatic system imaging was dynamically observed via Innova 2100-IQ digital flat-panel angiography system.Results All of them underwent direct lymphangiography.The results revealed unilateral(n =18) or bilateral (n =7) renal reflux of contrast media.Among 22 stenotic cases,there were partial(n =18)or whole (n =4)cervical section of thoracic duct,no imaging in cervicothoracic section of thoracic duct (n =1) ; thin imaging in cervical section and partial thoracic section (n =2) ; retroperitoneal lymphangictasia & tortuous lymphatic vessels (n =21) ; reflux of contrast medium to pelvic and/or contralateral sacroiliac part (n =13).Conclusion Capable of acquiring dynamic images of chyle (lymph) circulation,direct lymphangiography provides accurate estimation for the location,scope,extent of lesions of renal chylous reflux in primary chyluria so as to guide surgery.Stenotic cervical section of thoracic duct plays an important etiologic role in primary chyluria.