MRI による胸管の描出 - jrsca.jp

1 8 Fig. 1 Type VI TD(right TD with left out ow).Cisterna chyliis seen in the midline of the upper abdomen(arrowhead).Thethoracic duct(TD)runs along the right side of the aorta(A)and bends to the left in the supraclavicular region. The TD owsinto the left venous angle(arrow).8 .. MRI 1,2 2 31 2 3 1) MRI 12 65 1 78 MRI Magnetic resonance cholangiopancreatography(MRCP) 2D Prospective Acquistion CorrEc-tion(PACE) 3D turbo Spin Echo(TSE) Repetititopn Time(TR)/EchoTime(TE)/Echo Train Length(ETL) 4000 6000ms/616 ms/121 9 69 4 5 5 73 0 0 3 2 1 63 0 0 4 Table 1 2 MRI MRCP MRI T2 TE Magnetic Resonance-ThoracicDuctography(MRTD) MRTD 94 73/78 1/3 2/3 9 Thoracic duct depiction by MRI.

2 Embryological consideration of thoracic duct con gurationItsuko OKUDA1,2,YasuoNAKAJIMA2,KazuakiHIRATA31 Department of Diagnostic Radiology, Toranomon Hospital, Departoment of2 Radiology and3 Anatomy,St. Marianna University School of MedicineWe describe here the protocol of magnetic resonance-thoracic ductography(MRTD)and provide examples of thoracic duct(TD)andvarious anomalies. The anatomic pathway of the TD was analyzed based on embryological considerations. The TD con guration wasclassi edintoninetypesbasedonlocation(right and/or left side/s of the descending aorta)and out ow(right and/or left venous an-gle/s). The MRTD protocol included a long echo time and was based on enhancement of signals from the liquid fraction and suppres-sion of other signals, based on the principle that lymph ow through the TD appears hyperintense on T2 weighted images. MRTD wasconductedin78patientsandthe3 dimensional reconstruction was considered to provide an excellent view of the TD in 69,segmentalization of TD in 4 and poor view of the TD in 5 patients.

3 The majority of patients(n 63)had a right-side TD that owedinto the left venous angle. Major con guration variations were noted in 14 of cases. Minor anomalies such as divergence and mean-dering were frequently seen. MRTD allows non-invasive evaluation of TD and can be used to identify TD con words:thoracic duct, magnetic resonance imaging, esophageal cancer, lung cancer, MRTDT able 1 TD Con guration and Classi cation(n 73)Out owpositionLocationBilateral TDsRight TDLeft TDBilateralout owType n 0 Type n Type n 0 Rightout owType n 0 Type n Type n 0 Leftout owType n 34 Type n 6386 Type n 45 Adachi B, Kihara T, Das Lymphgef assystem der Japaner, 19539 MRI 2/3 1/3 2/3 1953 Adachi 261 9 MRTD Adachi 2) MRTD MRTD MRTD 86 63/73 14 2 MRI 1)Gabella G.

4 Cardiovascular system. 1995. In: Williams PL(ed),Gray's Anatomy, 38th Ed, Churchill Livingstone, New York,pp1451 16262)Adachi B. 1953 Der Ductus Thoracicus der Japaner. In: KiharaT(ed), Das Lymphgef asssystem der Japaner, Kenkyusha, Tokyo,pp1 83