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Abdominal lymphatic system visibility, morphology, and abnormalities in children as seen on routine MCRP and its

Ebtehaj AlShehri1, Christopher Z Lam1, Binita M Kamath2

  • 1Department of Diagnostic Imaging, The Hospital For Sick Children and Medical Imaging, University Of Toronto, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.

European Radiology
|August 16, 2020
PubMed

Insights

The thoracic duct and cisterna chyli are visible on MRCP in most children. Abnormal lymphatic collaterals are linked to immune-mediated diseases, suggesting the lymphatic system

Area of Science:

  • Radiology
  • Pediatric Imaging
  • Lymphatic System Research

Background:

  • The lymphatic system's role in inflammatory and immune-mediated diseases is increasingly recognized.
  • Understanding the visualization and characteristics of abdominal lymphatics in children is crucial for diagnosing related conditions.

Purpose of the Study:

  • To assess the visibility and diameters of the thoracic duct (TD) and cisterna chyli (CC) using MR cholangiopancreatography (MRCP) in children.
  • To identify lymphatic abnormalities and evaluate their association with immune-mediated diseases.

Main Methods:

  • Retrospective analysis of 142 MRCP examinations in children aged 8-17 years without prior surgery.
  • Two radiologists evaluated TD and CC visibility, diameters, and the presence of abnormal lymphatic collaterals.
  • Statistical analysis included Student's t tests for diameter comparisons and Fisher's exact tests for association with diseases.

Main Results:

  • The TD and CC were visualized in 93.7% and 88.7% of cases, respectively.
  • The mean cisterna chyli diameter was larger in patients with portal hypertension (p=0.021).
  • Retroperitoneal collaterals were observed in 28.8% of cases and were associated with portal hypertension (p=0.0019) and immune-mediated diseases (p=0.0083).

Conclusions:

  • Thoracic duct and cisterna chyli are routinely visualized in children over 8 years old via MRCP.
  • The cisterna chyli diameter is significantly larger in children with portal hypertension.
  • The association of collaterals with immune-mediated diseases supports the lymphatic system's role in their pathogenesis.
Abstract

Keywords:
ChildImmune system diseasesLymphatic systemMagnetic resonance cholangiopancreatographyPathology

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