Objective To investigate the imaging performance of CT lymphangiography(CTL)in patients with primary lower extremity lymphedema(LEL).Methods 42 patients with lower extremity swelling and diagnosed with LEL by lym-phangiography were retrospectively collected.All patients underwent conventional CT examination of the thoracoabdomi-nopelvic region after direct lymphangiography(DLG)with simultaneous reconstruction of CTL images,and the CTL and conventional thoracoabdominopelvic imaging manifestations were analyzed and statistically described using the composition ratio in the categorical variable data.Results CTL of 42 patients showed abnormal iodine oil deposition in different areas:terminal thoracic duct in 39 cases,right lymphatic duct in 7 cases,pleura in 9 cases,mediastinum in 12 cases,peritracheal bronchus in 9 cases,pericardium in 1 case,axilla in 9 cases,subdiaphragm in 28 cases,retroperitoneal space in 40 cases,mesentery in 15 cases,peri-intestine in 4 cases,peripancreatic in 9 cases,contralateral renal pelvis in 8 cases,lumbar trunk in 15 cases,iliac trunk in 28 cases,lateral renal pelvis in 5 cases,ground-glass opacity in 12 cases,iliac trunk in 42 cases,buttocks in 12 cases,perineum in 18 cases,and bone in 6 cases.The routine CT of the chest,abdomen and pelvis in 42 pa-tients showed ground-glass opacity(GGO)in 21 cases,solid shadow in 4 cases,pulmonary atelectasis in 5 cases,grid shad-ow in 19 cases,subpleural line sign in 4 cases,bud nodules in 3 cases,bronchial wall thickening in 19 cases,frog There were 3 cases of egg sign,7 cases of pleural effusion,14 cases of pleural thickening,5 cases of interlobular fissure thicken-ing,4 cases of pericardial effusion,5 cases of mediastinal fatty space clouding,5 cases of subcutaneous edema of the abdom-inopelvic wall,6 cases of intestinal wall thickening,11 cases of abdominopelvic effusion,16 cases of mesenteric swelling,8 cases of increased abdominopelvic/retroperitoneal lymph nodes,and 4 cases of increased inguinal lymph nodes.Conclu-sion Primary LEL is a systemic lymphatic duct abnormality.CTL examination can clarify the scope,location and degree of lymphatic duct abnormality,and clearly show the tissue and organs in the chest,abdomen and pelvis,providing valuable ima-ging information for the diagnosis and treatment of primary LEL.
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