BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two disea...BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two diseases.AIM To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.METHODS The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected retrospectively.CTL was performed in all patients.The clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were compared.The chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<0.05.RESULTS(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)patients.CONCLUSION CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax.This method is an excellent tool for diagnosing these two diseases.展开更多
Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant cas...Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography (MRL) using pre-contrast MR cholangiopancreatography (MRCP) and gadodiamideenhanced spectral presaturation inversion recovery (SPIR) T1-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.展开更多
Aim:The rationale of using liposuction to treat lymphedema is that the chronic inflammatory process of lymphedema results in fat hypertrophy.The authors describe the technique of indocyanine green lymphangiography-gui...Aim:The rationale of using liposuction to treat lymphedema is that the chronic inflammatory process of lymphedema results in fat hypertrophy.The authors describe the technique of indocyanine green lymphangiography-guided liposuction,its rationale,and our patient selection criteria for better clinical outcomes.Methods:Thirty-two patients underwent liposuction for breast cancer-related lymphedema.Indocyanine green lymphangiography was performed prior to liposuction.For patients without linear and splash patterns in indocyanine green lymphangiography,circumferential liposuction was performed liberally.For patients who had linear or splash patterns,liposuction was not performed at regions with remaining functional lymphatic vessels.Outcomes were assessed using circumferential reduction rate.Results:At a mean follow-up of 24.5±6.5 months,all(100%)patients had a reduction in limb circumferences after liposuction.The mean circumference reduction rate was 67.6%±27.9%.Conclusion:Liposuction is a valuable treatment for breast cancer-related lymphedema.We believe patients with fat predominant lymphedema are the best candidates for liposuction.展开更多
Applying indocyanine green(ICG)fluorescence in surgery has created a new dimension of navigation surgery to advance in various disciplines.The research in this field is nascent and fragmented,necessitating academic ef...Applying indocyanine green(ICG)fluorescence in surgery has created a new dimension of navigation surgery to advance in various disciplines.The research in this field is nascent and fragmented,necessitating academic efforts to gain a comprehensive understanding.The present review aims to integrate diverse perspectives and recent advances in its application in gastrointestinal surgery.The relevant articles were selected by using the appropriate keyword search in PubMed.The angiography and cholangiography property of ICG fluorescence is helpful in various hepatobiliary disorders.In gastroesophageal and colorectal surgery,the lymphangiography and angiography property of ICG is applied to evaluate bowel vascularity and guide lymphadenectomy.The lack of objective parameters to assess ICG fluorescence has been the primary limitation when ICG is used to evaluate bowel perfusion.The optimum dose and timing of ICG administration need to be standardized in some new application areas in gastrointestinal surgery.Binding tumor-specific ligands with fluorophores can potentially widen the fluorescence application to detect primary and metastatic gastrointestinal tumors.The narrative review outlines prior contributions,limitations,and research opportunities for future studies across gastrointestinal sub-specialty.The findings of the present review would be helpful for scholars and practitioners to explore and progress in this exciting domain of gastrointestinal surgery.展开更多
BACKGROUND Chylothorax is an uncommon condition in which chyle leaks into the pleural cavity,and biliary peritonitis is a rare complication of thoracic duct embolization in clinical practice.CASE SUMMARY We describe t...BACKGROUND Chylothorax is an uncommon condition in which chyle leaks into the pleural cavity,and biliary peritonitis is a rare complication of thoracic duct embolization in clinical practice.CASE SUMMARY We describe the case of a 50-year-old woman who presented with chylothorax and underwent thoracic duct embolization using a coil and a mixture of histoacryl glue and lipiodol.The patient developed upper abdominal pain and fever after the intervention.She was diagnosed with biliary peritonitis and treated with cholecystectomy at Hanoi Medical University Hospital.CONCLUSION Although thoracic duct embolization is considered a safe and minimally invasive procedure,it is not without risk.Following thoracic duct embolization,severe or persistent abdominal pain should be explored utilizing imaging data and laboratory results to determine problems as soon as possible.展开更多
Lymphedema is a major disorder of lymphatic system that occurs primarily due to lymphatic system disorders or secondary lymphedema which is caused by radiation therapy involving lymph nodes or surgical operation disse...Lymphedema is a major disorder of lymphatic system that occurs primarily due to lymphatic system disorders or secondary lymphedema which is caused by radiation therapy involving lymph nodes or surgical operation dissection. Magnetic resonance lymphography (MRL) has been used to effectively examine the lymph vessels and identify their morphology. This review study intended to evaluate the role of non MR-lymphographic for the diagnosis assessment of lymphedema and to provide comprehensive review on clinical outcome of non-contrast MRI compared to MRI with contrast medium. In this study, scientific publications published in languages other than English were excluded. A systematic review was done in international databases including PubMed, Scopus, web of sciences, conference proceedings published till 2019. Non contrast MRI lymphography has strong capability to be the main imaging procedure of choice in the diagnosis lymphedema with accuracy up to 90%.展开更多
Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedem...Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.展开更多
The management of chronic peripheral lymphedema benefits from a multidisciplinary approach in which magnetic resonance imaging(MRI)can play a key role.The imaging has been well described in the literature(including th...The management of chronic peripheral lymphedema benefits from a multidisciplinary approach in which magnetic resonance imaging(MRI)can play a key role.The imaging has been well described in the literature(including this journal),but the process for starting a novel imaging service line is complex.Participants in this process,including radiologists,imaging technical staff,information technologists,and revenue cycle managers,must be engaged and work in harmony to achieve success.The purpose of this article is to detail the building blocks and steps in starting a peripheral lymphedema MRI program,how our process evolved,and lessons learned along the way.展开更多
文摘BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two diseases.AIM To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.METHODS The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected retrospectively.CTL was performed in all patients.The clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were compared.The chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<0.05.RESULTS(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)patients.CONCLUSION CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax.This method is an excellent tool for diagnosing these two diseases.
基金Supported by the Medical and Health Sciences and Technology Program in Zhejiang province in 2014(2014KYA121)
文摘Chylothorax is a rare cause of pleural effusion in children, and it is usually difficult to identify the location of chyle leakage due to the small size of the thoracic duct in children. Herein we report an infant case with chylothorax whose leakage of the thoracic duct was successfully located by magnetic resonance lymphangiography (MRL) using pre-contrast MR cholangiopancreatography (MRCP) and gadodiamideenhanced spectral presaturation inversion recovery (SPIR) T1-weighted imaging, which demonstrate the imaging method is easy and effective for detecting the focal disruption of the thoracic duct in children with chylothorax and younger than 8 months old.
文摘Aim:The rationale of using liposuction to treat lymphedema is that the chronic inflammatory process of lymphedema results in fat hypertrophy.The authors describe the technique of indocyanine green lymphangiography-guided liposuction,its rationale,and our patient selection criteria for better clinical outcomes.Methods:Thirty-two patients underwent liposuction for breast cancer-related lymphedema.Indocyanine green lymphangiography was performed prior to liposuction.For patients without linear and splash patterns in indocyanine green lymphangiography,circumferential liposuction was performed liberally.For patients who had linear or splash patterns,liposuction was not performed at regions with remaining functional lymphatic vessels.Outcomes were assessed using circumferential reduction rate.Results:At a mean follow-up of 24.5±6.5 months,all(100%)patients had a reduction in limb circumferences after liposuction.The mean circumference reduction rate was 67.6%±27.9%.Conclusion:Liposuction is a valuable treatment for breast cancer-related lymphedema.We believe patients with fat predominant lymphedema are the best candidates for liposuction.
文摘Applying indocyanine green(ICG)fluorescence in surgery has created a new dimension of navigation surgery to advance in various disciplines.The research in this field is nascent and fragmented,necessitating academic efforts to gain a comprehensive understanding.The present review aims to integrate diverse perspectives and recent advances in its application in gastrointestinal surgery.The relevant articles were selected by using the appropriate keyword search in PubMed.The angiography and cholangiography property of ICG fluorescence is helpful in various hepatobiliary disorders.In gastroesophageal and colorectal surgery,the lymphangiography and angiography property of ICG is applied to evaluate bowel vascularity and guide lymphadenectomy.The lack of objective parameters to assess ICG fluorescence has been the primary limitation when ICG is used to evaluate bowel perfusion.The optimum dose and timing of ICG administration need to be standardized in some new application areas in gastrointestinal surgery.Binding tumor-specific ligands with fluorophores can potentially widen the fluorescence application to detect primary and metastatic gastrointestinal tumors.The narrative review outlines prior contributions,limitations,and research opportunities for future studies across gastrointestinal sub-specialty.The findings of the present review would be helpful for scholars and practitioners to explore and progress in this exciting domain of gastrointestinal surgery.
文摘BACKGROUND Chylothorax is an uncommon condition in which chyle leaks into the pleural cavity,and biliary peritonitis is a rare complication of thoracic duct embolization in clinical practice.CASE SUMMARY We describe the case of a 50-year-old woman who presented with chylothorax and underwent thoracic duct embolization using a coil and a mixture of histoacryl glue and lipiodol.The patient developed upper abdominal pain and fever after the intervention.She was diagnosed with biliary peritonitis and treated with cholecystectomy at Hanoi Medical University Hospital.CONCLUSION Although thoracic duct embolization is considered a safe and minimally invasive procedure,it is not without risk.Following thoracic duct embolization,severe or persistent abdominal pain should be explored utilizing imaging data and laboratory results to determine problems as soon as possible.
文摘Lymphedema is a major disorder of lymphatic system that occurs primarily due to lymphatic system disorders or secondary lymphedema which is caused by radiation therapy involving lymph nodes or surgical operation dissection. Magnetic resonance lymphography (MRL) has been used to effectively examine the lymph vessels and identify their morphology. This review study intended to evaluate the role of non MR-lymphographic for the diagnosis assessment of lymphedema and to provide comprehensive review on clinical outcome of non-contrast MRI compared to MRI with contrast medium. In this study, scientific publications published in languages other than English were excluded. A systematic review was done in international databases including PubMed, Scopus, web of sciences, conference proceedings published till 2019. Non contrast MRI lymphography has strong capability to be the main imaging procedure of choice in the diagnosis lymphedema with accuracy up to 90%.
文摘Lymphedema is a chronic and progressive pathological state of tissue swelling caused by congenital or acquired lymphatic abnormality.History,physical and laboratory examinations could help to diagnosis>90%lymphedema patients.Early stage lymphedema could be challenging to diagnose.The aim of this review is to provide an objective appraisal of current diagnostic methods,such as lymphoscintigraphy,lympho-fluoroscopies,lymphangiography and etc.focusing on their respective advantages and weaknesses,and hopefully shed some lights on developing a practical diagnosis modality beneficial to early detection and clinical decision making of lymphedema.
文摘The management of chronic peripheral lymphedema benefits from a multidisciplinary approach in which magnetic resonance imaging(MRI)can play a key role.The imaging has been well described in the literature(including this journal),but the process for starting a novel imaging service line is complex.Participants in this process,including radiologists,imaging technical staff,information technologists,and revenue cycle managers,must be engaged and work in harmony to achieve success.The purpose of this article is to detail the building blocks and steps in starting a peripheral lymphedema MRI program,how our process evolved,and lessons learned along the way.
