Objective To investigate the diagnostic value of CT lymphangiography(CTL)in primary chylopericardi-um.Methods The clinical and imaging data of 39 patients with primary chylopericardium were retrospectively analyzed.All patients underwent CTL scan.CTL was used to evaluate the abnormal distribution of contrast agents in the neck,chest,abdomen and pelvis,reflux and abnormal manifestations of pericardium,mediastinum and lungs.The composition ratio of qualitative data was used for statistical description.Results All 39 patients with CTL showed abnormal iodine oil deposi-tion and reflux at different sites:(1)neck:11 cases of the end of thoracic duct,3 cases of the end of right lymphatic duct,24 cases of cervical trunk reflux,25 cases of subclavian trunk reflux;(2)chest:23 cases of bronchial mediastinal trunk re-flux,22 cases of anterior mediastinum,12 cases of main pulmonary artery window,29 cases of peritracheal and bronchial,30 cases of subcarina,24 cases of posterior mediastinum,7 cases of thoracic duct trunk reflux,15 cases of pericardial reflux,11 of which were transbronchial mediastinal trunk reflux,and 10 cases of abnormal distribution of intercostal,pleural,and Su-pra-diaphragm.(3)Abnormalities in the abdomen and pelvic region:4 cases in the subdiaphragm,18 cases of dilated and condensed iliac lymphatics on the contrast side,21 cases of contralateral iliac reflux,16 cases of abnormal distribution of contrast in the ipsilateral lumbar trunk,and 23 cases of contralateral lumbar trunk reflux.Extra-lymphatic manifestations of abnormalities:39 cases showed fluid density in the pericardial cavity,2 cases showed cloudy and swollen mediastinal soft tis-sues,24 cases showed abnormalities in both lungs,10 cases showed thickened lobular septa,11 cases showed ground glass density,10 cases showed thickened broncho vascular bundles,5 cases showed thickened bronchial walls,16 cases showed pleural effusion,and 11 cases showed pulmonary atelectasis or insufficiency.16 patients were treated surgically and 7 cases were relieved after surgery.Conclusion CT lymphangiography can show the abnormalities of thoracic duct and accessory branches in primary chylopericardium,and abnormal lesions of mediastinum,pericardium and lungs in this disease,which can help to explore the pathogenesis,diagnosis and differential diagnosis of this disease.
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