Acta Veterinaria et Zootechnica Sinica ›› 2024, Vol. 55 ›› Issue (11): 4890-4899.doi: 10.11843/j.issn.0366-6964.2024.11.010
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Bo KANG1(), Ruize GUO2, Di ZHANG1,2,*(
)
Received:
2024-01-02
Online:
2024-11-23
Published:
2024-11-30
Contact:
Di ZHANG
E-mail:ps20223051074@cau.edu.cn;dzhangdvm@cau.edu.cn
CLC Number:
Bo KANG, Ruize GUO, Di ZHANG. Application of Computed Tomography Lymphangiography in Diagnosis and Treatment of Cat Chylothorax[J]. Acta Veterinaria et Zootechnica Sinica, 2024, 55(11): 4890-4899.
Fig. 1
A 4-year-old male castrated American short hair cat presented with polypnea. A ventrodorsal view of thorax X-ray showed an enlarged cardiac silhouette, increased density in the posterior part of the left anterior lobe and in the inner bands of the lung fields bilaterally, bluntly rounded edges of the lung fields bilaterally, and an interlobular pleural fissure line visible in the left 6-7 intercostal space (arrow). It suggests the presence of pulmonary oedema and a small amount of pleural effusion"
Fig. 2
A 4-year-old male domesticated long hair cat presented with dyspnoea and cough. A ventrodorsal view of thorax X-ray showed an ill-defined cardiac silhouette, bilateral lung lobe retraction (arrows), and soft tissue density in the thoracic cavity. It suggested bilateral massive pleural effusion and pulmonary atelectasis"
Fig. 3
A 6-month-old male American short hair cat presented with dyspnoea. X-ray evidence of pleural effusion. The thoracic ultrasonography in the right lateral position revealed many echogenic dark areas in the right thoracic cavity, with segregation (arrow) in the dark areas, with a depth of about 2.66 cm. It suggested that the right thoracic cavity was effused, with the formation of segregation in the pleural cavity"
Table 1
Comparison of methods of CT lymphangiography in canine and feline"
名称 Name | 引导方法 Method of guidance | 造影剂种类/(I,mg·mL–1) Types of contrast agent | 造影剂剂量/(mL·kg–1) Dose of contrast agent | 注射位点 Injection points | 扫描时间/min Scan time |
开腹直视下经肠系膜淋巴管注射CT淋巴管造影 CT lymphangiography via mesenteric lymphatic capillary injection under laparotomy | 开腹直视 Laparotomy | 碘海醇300 Iohexol 300 | 犬1 猫1 Canine 1 Feline 1 | 肠系膜淋巴管 Mesenteric lymphatic capillary | 立即 Immediately |
超声引导下经肠系膜淋巴结注射CT淋巴管造影 CT lymphangiography via mesenteric lymph node under ultrasound guided | 超声 Ultrasound | 碘海醇300 Iohexol 300 | 犬1.5~2 mL·只-1 猫1.5 mL·只-1 Canine 1.5~2 mL a dog Feline 1.5 mL a cat | 肠系膜淋巴结 Mesenteric lymph node | 犬2、5 猫3、6 Canine 2,5 Feline 3,6 |
经肛周皮下注射CT淋巴管造影 Perianal hypodermic CT lymphangiography | 无 None | 碘帕醇370 Iopamidol 370 | 犬0.6 猫1.2~1.8 Canine 0.6 Feline 1.2~1.8 | 肛周分点注射 Perianal fractional injection | 犬5、10 猫5、10、15 Canine 5,10 Feline 5,10, 15 |
超声引导下经腘淋巴结注射CT淋巴管造影 CT lymphangiography via popliteal lymph node injection under ultrasound guided | 超声 Ultrasound | 碘海醇350 Iohexol 350 | 犬0.17~1 猫1.5 Canine 0.17~1 Feline 1.5 | 单侧腘淋巴结 Unilateral popliteal lymph node | 犬3、6、9、12 猫3、5、7 Canine 3, 6, 9, 12 Feline 3, 5, 7 |
经跖骨背侧皮下注射CT淋巴管造影 Transmetatarsal dorsal hypodermic CT lymphangiography | 无 None | 碘海醇300 Iohexol 300 | 犬0.75~1 Canine 0.75~1 | 单侧跖骨背侧皮下 Unilateral transmetatarsal dorsal hypodermic | 犬3、5、7 Canine 3, 5, 7 |
经跖垫内注射CT淋巴管造影 CT lymphangiography via intraplantar pad injection | 无 None | 碘海醇350 Iohexol 350 | 犬1 猫1 Canine 1 Feline 1 | 双后肢跖垫内 Intraplantar pad of both hindlimbs | 犬5、8、11、14 猫3、6、9、12 Canine 5, 8, 11, 14 Feline 3, 6, 9, 12 |
超声引导下经皮肝脏穿刺注射CT淋巴管造影 CT lymphangiography via percutaneous hepatic puncture injection under ultrasound guided | 超声 Ultrasound | 碘帕醇370 Iopamidol 370 | 猫1~1.5 Feline 1~1.5 | 肝右内叶或肝左内叶 Right inner lobe of the liver or left inner lobe of the liver | 猫5、10、15 Feline 5, 10, 15 |
Fig. 6
A 4-year-old male castrated domestic short hair cat presented with dyspnoea and cyanosis. A prone CT scan (transverse section left ventricular outflow tract level) that showed bilateral ventral massive fluid density shadows in the thoracic cavity, with a mean CT value of approximately 7 HU. The ventral pleura thickened with a soft-tissue density (arrows). It suggested that bilateral massive pleural effusions with pleurisy. Mediastinal window, window level: 40 HU, window width: 400"
Fig. 7
The same cat as shown in Fig. 6 perform a CT lymphangiography. A: Maximum intensity projection (MIP) in the sagittal plane shows the thoracic duct and the celiac pool (arrows) (bone window, window level: 300 HU, window width: 1500). B: Transverse section in prone position at the level of the 3rd thoracic vertebrae reveals high density (arrow) on the ventral side of the left intrathoracic cavity, considering contrast leakage deposited on the gravitational side of the intrathoracic cavity (mediastinal window, window level: 40 HU, window width: 400). C: Transverse section in prone position at the level of the 12th thoracic vertebrae shows the branch of the thoracic duct dorsal to the aorta in high density (arrows). Preoperative scanning helps to differentiate the thoracic duct alignment and its branches and assists in surgical planning (mediastinal window, window level: 40 HU, window width: 400). D: CT lymphangiography was performed after thoracic duct ligation, and the maximum intensity projection (MIP) in the sagittal plane showed high density in the thoracic duct up to the level of the L2 vertebral body, with no visualization at the distal end, suggesting that the ligation had been successful. Multiple high-density images (arrow) of the ventral aspect of the vertebral body at the level of the T11-T12 were surgical titanium clips (bone window, window level: 300 HU, window width: 1 500)"
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