Evaluation of the left neck distal thoracic duct in cirrhosis with computed tomography

To evaluate the left distal thoracic duct (DTD) in the lower neck area by using contrast-enhanced chest computed tomography (CT) in patients with liver cirrhosis (LC).

In 156 consecutive subjects who performed the contrast-enhanced chest CT, examinations were retrospectively reviewed. The diameters of the left DTD were measured by using CT. Depending on the diameter of the left DTD, the left DTD configurations were classified into four grades: grade 0 (no identification of DTD), grade I (diameter <5mm), grade II (diameters ≥5mm and <10mm), and grade III (diameter ≥10mm). Depending on the liver status, all 156 subjects were divided into three groups: (a) noncirrhotic liver group (n=55), (b) compensated LC group (n=88), and (c) decompensated LC group (n=13).

Among the 156 left DTD configurations, 81 (52%), 60 (39%), 10 (6%), and only 4 (3%) were assigned to the grade 0, I, II, and III, respectively. The noncirrhotic liver group included 45 (82%) grade 0 and 10 (18%) grade I subjects. The compensated LC group included 37 (42%) grade 0, 50 (57%) grade I, and 1 (1%) grade II subjects. In contrast, the decompensated LC group included 9 (69%) grade II and 4 (31%) grade III subjects.

When reviewed the contrast-enhanced chest CT, the left DTD can be identified more frequently in subjects with LC than in those with noncirrhotic liver. Furthermore, the degree of left DTD dilation may be associated with the severity of LC.