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Central Lymphatic Imaging in Adults with Spontaneous Chyluria
Tran Quoc Hoa1, Nguyen Ngoc Cuong2, Nguyen Cong Hoan3
1Surgery Urology, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam.
International Journal of General Medicine
|June 3, 2024
Summary
Chyluria diagnosis is improved by combining Magnetic Resonance Lymphangiography (MRL) and Intranodal Lymphangiography (IL). These imaging techniques help visualize lymphatic vessels and uro-lymphatic fistulas, aiding in understanding chyluria
Area of Science:
- Medical Imaging
- Vascular Anatomy
- Urology
Background:
- Chyluria is a rare condition involving lymphatic and urinary tract communication, predominantly in tropical regions.
- The precise mechanism of uro-lymphatic fistula formation in chyluria remains unclear.
Purpose of the Study:
- To assess the morphology of main lymphatic vessels, including uro-lymphatic fistulas and the thoracic duct.
- To evaluate the utility of Magnetic Resonance Lymphangiography (MRL) and Intranodal Lymphangiography (IL) in diagnosing chyluria.
Main Methods:
- A retrospective study of 43 chyluria patients (Jan 2020-Jan 2024).
- Diagnosis confirmed by cystoscopy and urine triglyceride testing.
- Patients underwent MRL followed by IL for uro-lymphatic fistula embolization.
Main Results:
- Uro-lymphatic fistulas were most common on the left (72.1%).
- MRL visualized the thoracic duct in 100% but fistulas in 84.5%.
- IL visualized fistulas in 100% but the thoracic duct in 51.5%.
Conclusions:
- MRL and IL are complementary diagnostic tools for chyluria.
- Thoracic duct circulatory stasis may increase pressure, leading to uro-lymphatic fistula formation.
- These findings support the collateral circulation hypothesis in chyluria pathogenesis.
