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CT Lymphangiography (CTL) in Primary Intestinal Lymphangiectasia (PIL): A Comparative Study with Intraoperative Enteroscopy (IOE).
- Source :
-
Academic radiology [Acad Radiol] 2019 Feb; Vol. 26 (2), pp. 275-281. Date of Electronic Publication: 2018 Jun 06. - Publication Year :
- 2019
-
Abstract
- Rationale and Objectives: To investigate the clinical feasibility of CT lymphangiography (CTL) in primary intestinal lymphangiectasia (PIL) by comparison with intraoperative enteroscopy (IOE) during exploratory laparotomy.<br />Materials and Methods: Eleven PIL patients (F/M, two/nine, age range 10-37 years) were recruited in this study, and they were performed IOE during exploratory laparotomy for suspected serious lymphatic-intestinal leakages. All the patients were performed CTL before surgery, and the imaging data were reviewed by two radiologists separately. CTL assessments included intestinal lesions, edematous lesions, intestinal and mesenteric lymphangiectasia, lymphaticabdominal leakages, lymph fluid reflux, lymphangioma and abnormal lymphatics in other area. The intestinal lymphangiectasia and lymphaticintestinal leakages were confirmed by histology and IOE.<br />Results: For CTL, (1) nine intestinal wall thickening; (2) eight ascites, complicated with four pleural effusions, (3) eight intestinal and mesenteric lymphangiectasia, (4) six lymph fluid reflux (5) one lymphatic-abdominal leakage, (6) two lymphangioma. While for IOE, intestinal lymphangiectasia has been confirmed in all patients, including five segemental and six diffusive lesions in intestinal mucosa. Besides, one lymphatic-intestinal fistula, one lymphatic-abdominal leakage was confirmed. Compared to IOE and histology, the accuracy of CTL was 72.7% in detecting intestinal lymphangiectasia.<br />Conclusion: Compared to IOE, CTL demonstrates feasibility in detection of intestinal lymphangiectasia and other abnormalities in whole lymphatic circulation for PIL. Combination of CTL with IOE accommodates guidance for preoperative evaluation and therapeutic management for PIL.<br /> (Copyright © 2018 Academic Radiology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Child
Feasibility Studies
Female
Humans
Intraoperative Care methods
Male
Preoperative Care methods
Balloon Enteroscopy methods
Laparotomy methods
Lymphangiectasis, Intestinal diagnosis
Lymphangiectasis, Intestinal surgery
Lymphography methods
Tomography, X-Ray Computed methods
Subjects
Details
- Language :
- English
- ISSN :
- 1878-4046
- Volume :
- 26
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Academic radiology
- Publication Type :
- Academic Journal
- Accession number :
- 29885759
- Full Text :
- https://doi.org/10.1016/j.acra.2018.04.023