CT Lymphangiography (CTL) in Primary Intestinal Lymphangiectasia (PIL): A Comparative Study with Intraoperative Enteroscopy (IOE).

Authors:
Jian Dong
Jian Dong
Zhongshan Hospital
China
Jianfeng Xin
Jianfeng Xin
Beijing Shijitan Hospital
Wenbin Shen
Wenbin Shen
China Pharmaceutical University
China
Tingguo Wen
Tingguo Wen
Capital Medical University
Xiaobai Chen
Xiaobai Chen
Beijing Shijitan Hospital
China
Yuguang Sun
Yuguang Sun
Beijing Police Hospital
China
Rengui Wang
Rengui Wang
Peking University First Hospital
China

Acad Radiol 2019 Feb 6;26(2):275-281. Epub 2018 Jun 6.

Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi St, Haidian District, Beijing 100038, China. Electronic address:

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.

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.

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.

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.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S10766332183023
Publisher Site
http://dx.doi.org/10.1016/j.acra.2018.04.023DOI Listing
February 2019
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