Cargando…

Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax

A preschool male patient with an extensive cardiac surgical history developed refractory chylothorax after a total cavopulmonary connection. Neither lymphoscintigraphy nor single-photon emission computed tomography (SPECT)/computed tomography could identify the lymphatic system leakage sites. Non-co...

Descripción completa

Detalles Bibliográficos
Autores principales: Shima, Takashi, Hara, Takuya, Sato, Keisuke, Kan, Nobuhiko, Kinjo, Tadamune
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925839/
https://www.ncbi.nlm.nih.gov/pubmed/36798069
http://dx.doi.org/10.1016/j.radcr.2023.01.021
_version_ 1784888143289253888
author Shima, Takashi
Hara, Takuya
Sato, Keisuke
Kan, Nobuhiko
Kinjo, Tadamune
author_facet Shima, Takashi
Hara, Takuya
Sato, Keisuke
Kan, Nobuhiko
Kinjo, Tadamune
author_sort Shima, Takashi
collection PubMed
description A preschool male patient with an extensive cardiac surgical history developed refractory chylothorax after a total cavopulmonary connection. Neither lymphoscintigraphy nor single-photon emission computed tomography (SPECT)/computed tomography could identify the lymphatic system leakage sites. Non-contrast heavy T2-weighted magnetic resonance lymphangiography (MRL) was performed to visualize the lymphatic system. Nevertheless, distinguishing lymphatic ducts from other watery structures of the patient remained difficult. Therefore, non-contrast MRL and SPECT images were fused. This hybrid diagnostic tool elucidated the pathophysiology of the prolonged chylothorax; pulmonary lymphatic perfusion syndrome and illustrated the anatomical connection of the thoracic duct and an abnormally dilated lymphatic network in the neck and left hilar regions. Subsequent intranodal lymphangiography with ethiodized oil confirmed these findings. SPECT/MRL may become an alternative modality for revealing the mechanism of prolonged chylothorax by visualizing the lymphatic system when dynamic contrast-enhanced magnetic resonance lymphangiography is unavailable.
format Online
Article
Text
id pubmed-9925839
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-99258392023-02-15 Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax Shima, Takashi Hara, Takuya Sato, Keisuke Kan, Nobuhiko Kinjo, Tadamune Radiol Case Rep Case Report A preschool male patient with an extensive cardiac surgical history developed refractory chylothorax after a total cavopulmonary connection. Neither lymphoscintigraphy nor single-photon emission computed tomography (SPECT)/computed tomography could identify the lymphatic system leakage sites. Non-contrast heavy T2-weighted magnetic resonance lymphangiography (MRL) was performed to visualize the lymphatic system. Nevertheless, distinguishing lymphatic ducts from other watery structures of the patient remained difficult. Therefore, non-contrast MRL and SPECT images were fused. This hybrid diagnostic tool elucidated the pathophysiology of the prolonged chylothorax; pulmonary lymphatic perfusion syndrome and illustrated the anatomical connection of the thoracic duct and an abnormally dilated lymphatic network in the neck and left hilar regions. Subsequent intranodal lymphangiography with ethiodized oil confirmed these findings. SPECT/MRL may become an alternative modality for revealing the mechanism of prolonged chylothorax by visualizing the lymphatic system when dynamic contrast-enhanced magnetic resonance lymphangiography is unavailable. Elsevier 2023-02-01 /pmc/articles/PMC9925839/ /pubmed/36798069 http://dx.doi.org/10.1016/j.radcr.2023.01.021 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Shima, Takashi
Hara, Takuya
Sato, Keisuke
Kan, Nobuhiko
Kinjo, Tadamune
Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title_full Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title_fullStr Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title_full_unstemmed Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title_short Fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-Fontan chylothorax
title_sort fusion imaging of single-photon emission computed tomography and magnetic resonance lymphangiography for post-fontan chylothorax
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925839/
https://www.ncbi.nlm.nih.gov/pubmed/36798069
http://dx.doi.org/10.1016/j.radcr.2023.01.021
work_keys_str_mv AT shimatakashi fusionimagingofsinglephotonemissioncomputedtomographyandmagneticresonancelymphangiographyforpostfontanchylothorax
AT haratakuya fusionimagingofsinglephotonemissioncomputedtomographyandmagneticresonancelymphangiographyforpostfontanchylothorax
AT satokeisuke fusionimagingofsinglephotonemissioncomputedtomographyandmagneticresonancelymphangiographyforpostfontanchylothorax
AT kannobuhiko fusionimagingofsinglephotonemissioncomputedtomographyandmagneticresonancelymphangiographyforpostfontanchylothorax
AT kinjotadamune fusionimagingofsinglephotonemissioncomputedtomographyandmagneticresonancelymphangiographyforpostfontanchylothorax