摘要
目的探讨不同发病年龄类型原发性下肢淋巴水肿患者磁共振胸导管成像(MRTD)显影情况的区别。方法回顾性分析88例原发性淋巴水肿患者的临床和MRTD资料,按照发病年龄将患者分为四组,先天性组(出生后即存在水肿),早发性Ⅰ组(20岁前发病),早发性Ⅱ组(20~35岁发病),迟发性组(35岁后发病)。对每例患者MRTD胸导管分四段(腹段,胸段下1/2,胸段上1/2,颈段)进行评分,每段0~2分。非参数检验比较各组胸导管评分差异。结果先天性组胸导管总评分4.0(2.0,6.0),早发性Ⅰ组总评分5.6±1.8,早发性Ⅱ组总评分5.6±2.0,迟发性组总评分6.5(4.8,8.0)。先天性组与其他三组评分差异有统计学意义(P<0.05)。其他组间评分差异无统计学意义。仅胸段上1/2评分各组间差异有统计学意义(P<0.05),其他各段评分组间差异无统计学意义。结论MRTD可以无创性显示原发性淋巴水肿患者胸导管。先天性患者胸导管存在更明显胸导管发育不良或瘪陷,提示存在更重的淋巴管系统发育异常,可能是其发病时间早的一个因素。
Objective To explore differences of the thoracic duct in patients with different onset types of primary lym-phoedema,using magnetic resonance thoracic ductography(MRTD).Methods The study was conducted on 88 patients with primary lymphoedema.MRTD data was analyzed retrospectively.The patients were dividedinto 4 groups by the age of onset:thecongenital group(onset at birth),the lymphoedema praecoxgroupⅠ(onset before 20),the lymphoedema praecox groupⅡ(onset between20-35),lymphoedema tardagroup(onset after 35).Every thoracic duct was divided in 4 sections:abdominal section,thoracic section lower 1/2,thoracic section upper 1/2,and cervical section.Every section was evaluated by a 0-2’method.Non-parametric test(Kruskal-Wallis H test)was used to compare the scores between the 4 groups.Re-sults Thescores of display of thoracic ducts:the congenital group 4.0(2.0,6.0),the lymphoedema praecox groupⅠ5.6±1.8,the lymphoedema praecox groupⅡ5.6±2.0,lymphoedema tarda group6.5(4.8,8.0).The differencesbetween the congenital group and any of the other three groups were statistically significant(P<0.05).No significant differences were found in scores between any two of the other groups.There were statistically significant differences in scores of thoracic sec-tion upper 1/2 among the groups(P<0.05).No significant differences were found in scores of any other 3 sections among groups.Conclusion MRTD is a noninvasive method for diagnosis of thoracic duct abnormalities in patients with primary lymphoedema of lower extremities.Severer dysplasia or collapse of thoracic duct were found in patients with congenital lym-phoedema,may be related to the early onset of the disease.
作者
孔令
岳云龙
沈文彬
温廷国
陈孝柏
金延方
黄俊
王仁贵
KONG Ling;YUE Yunlong;SHEN Wenbin(Department of Radiologry,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第12期2298-2302,共5页
Journal of Clinical Radiology
基金
北京市属医院科研培育计划基金项目(编号:PX2017049)
关键词
胸导管
磁共振成像
原发性淋巴水肿
Thoracic duct
Magnetic resonance imaging
Primary lymphoedema
