Thoracic duct | Radiology Reference Article | az-links.info
Gross anatomy; Relations; Variant anatomy; Related pathology; Related The thoracic duct is the superior continuation of the cisterna chyli at the level of the L1 . The thoracic duct is the largest lymphatic vessel within the human body, and plays a key role in the lymphatic system. It is also called the left lymphatic duct or the. The position of thoracic duct with respect to the vertebra and relationships with . Thoracic duct and cisterna chyli injuries may cause chylous leakage which is.
Abstract Objectives The aim of this study was to evaluate the normal anatomy of the thoracic duct and cisterna chyli obtained by axial and multiplanar reformation MPR images of 1 mm slice thickness using multidetector row CT MDCT. Methods We evaluated the ability of MDCT to examine the normal anatomy of the thoracic duct and cisterna chyli. The axial and coronal images of thoracoabdominal MDCT images obtained in 50 patients 20 females and 30 males; mean age, We excluded patients with malignant neoplasms, inflammation or vascular diseases e.
The thoracic duct was divided into three anatomical sections: We evaluated the degree of visualisation and the maximum size of the thoracic duct. We also evaluated the degree of visualisation, maximum size, configuration and location of the cisterna chyli. The lower section of the thoracic duct was most clearly visualised among the three sections.
There was little difference in the maximum size of the thoracic duct among the three sections. The thoracic duct is the main collecting vessel of the lymphatic system. It drains three-quarters of the lymph in the body into the venous blood stream. The lymphatic system, which connects the lymphatics of various organs, is an important network for the circulation of fluid throughout the body [ 12 ].
The lymph from the lower limb finally terminates at the para-aortic nodes. They join with the lymph from the viscera of the pelvis and form bilateral lumbar trunks. The intestinal trunks consist of large lymphatic vessels that receive lymph from the stomach, intestine, pancreas and spleen. The cisterna chyli receives the lymph from bilateral lumbar trunks, along with the intestinal trunks. The thoracic duct frequently drains into the junction of the left jugular and subclavian veins [ 12 ].
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The lymphatic system is involved in various pathological conditions, including neoplastic diseases that can result in disturbances of lymphatic flow. Furthermore, laceration of the thoracic duct sometimes occurs after surgery for example, oesophagectomy, pneumonectomy and spine surgeryand these result in incurable chylothorax.
Therefore, it is necessary to recognise its precise location before surgery. It is difficult for conventional CT and MRI to visualise the lymphatic system because of its thin and complicated structures. Lymphangiography and lymphoscintigraphy were originally the only methods to visualise the lymphatic system, but recently MR lymphography has become feasible for visualising the lymphatic system.
Recently, there have been some reports regarding the evaluation of the thoracic duct and the cisterna chyli by using MDCT [ 34 ]. The purpose of this study was to evaluate the normal anatomy of the thoracic duct and the cisterna chyli by axial and MPR images of 1 mm slice thickness using MDCT. Anatomical considerations The cisterna chyli is the abdominal origin of the thoracic duct, and it receives the bilateral lumbar lymphatic trunks.
This article has been cited by other articles in PMC. Abstract The aim of this study is to localize and document the anatomic features of the thoracic duct and its tributaries with special emphasis on the spinal surgery point of view.
The thoracic ducts were dissected from nine formaldehyde-preserved male cadavers. The drainage patterns, diameter of the thoracic duct in upper, middle and lower thoracic segments, localization of main tributaries and morphologic features of cisterna chyli were determined.
The thoracic duct was detected in all cadavers. The main tributaries were concentrated at upper thoracic between third and fifth thoracic vertebrae and lower thoracic segments below the level of ninth thoracic vertebra at the right side. However, the main lymphatic tributaries were drained into the thoracic duct only in the lower thoracic area below the level of the tenth thoracic vertebra at the left side. Two major anatomic variations were detected in the thoracic duct.
Thoracic duct and cisterna chyli: evaluation with multidetector row CT
In the first case, there were two different lymphatic drainage systems. In the second case, the thoracic duct was found as bifid at two different levels. In formaldehyde preservation, the dimensions of the soft tissues may change. For that reason, the dimensions were not discussed and they may not be a guide in surgery.
Additionally, our study group is quite small. Larger series may be needed to define the anatomic variations. As a conclusion, anatomic variations of the thoracic duct are numerous and must be considered to avoid complications when doing surgery. Thoracic duct, Anatomy, Spine surgery, Complication, Variation Introduction The thoracic duct is the primary lymphatic vessel and it collects the lymphatic fluid from all the minor lymphatic vessels.
- Thoracic Duct
- Cisterna chyli
- Thoracic duct and cisterna chyli: evaluation with multidetector row CT
Its distal dilated origin is known as cisterna chyli and it is usually located on the anterior surface of the first or second lumbar vertebra.
It extends superiorly and usually drains into the left subclavian vein [ 37 ]. Thoracic duct injury and chylous leakage is a rare complication in spine surgery.