Spatial Relationships of the Cisterna Chyli and Abdominal Venous Vasculature on MRI

In the field of interventional radiology, transvascular routes of access to adjacent structures have led to shorter procedure times and fewer complications. No transvenous approach to intervene on the lymphatic ducts currently exists, nor do any standard measurements of the inferior vena cava (IVC) and cisterna chyli (CC). This retrospective review of cross-sectional imaging studies consisted of 150 adults (age 57±17.8) who obtained a magnetic resonance pancreatography (MRCP) for a variety of clinical indications. Of those, 8 patients had poor image quality and 28 did not have an identifiable CC. The remaining 114 images were evaluated for size, caliber, and orientation of anatomic structures of interest using a PACS workstation. The average distance between the center of the IVC to the center of the CC was found to be 24.3 mm (11.1-50.5 mm). The angle relative to anterior-posterior as determined by the spine ranged from 21.0° anterior to 103.0° posterior. Important intervening structures included the renal artery (19.30%), liver (7.02%), and aorta (4.39%). The short spatial approximation of the IVC and CC and the rarity of intervening structures support further development of transvascular CC access techniques.