Die Cisterna chyli: Evaluation von Prävalenz, Charakteristika und prädisponierenden Faktoren anhand von Computertomographien
Auch gedruckt in der BibliothekZ: J-H 14.131; W: W-H 12.594
Ressourcen- / MedientypDissertation, Text
Datum der Freischaltung2011-07-21
In this retrospective study computer tomographies (CT) of 3000 patients were evaluated to determine the prevalence, morphological characteristics and potential predisposing factors, which can contribute to the development of a cisterna chyli (CC). The evaluation of all 3000 CTs occurred consecutively, in which exclusively contrast enhanced CT examinations of the chest and/or abdomen were included. The verification of a CC, the size, the volume, the attenuation as well as the localization were correlated with the anamnestic and clinical data of all patients. Among all 3000 patients 484 CC (16,1 %) were definitely existent by a small male predominance. The mean distention of a CC was sagittal 5,9 mm, transversal 6,4 mm and craniocaudal 13,1 mm, corresponding a mean volume of 302 µl. The mean attenuation of all CC was 4,8 Hounsfield units (HU). More than every 4th CC (28,3 %) showed CT densities above 10 HU. To use the CT attenuation similar to water as an exclusive distinctive feature between a CC and an augmented retrocrural lymph node can lead easily to misinterpretation. A much safer method to distinguish the CC from a retrocrural lymph node independently of the CT attenuation is to detect the continuity of the CC into the thoracic duct. Among the senior age patients there was significant more often a CC detectable than in younger age groups. Patients with malignancies showed a significantly higher prevalence (p < 0,001) for a CC (341/1757; 19,4 %) than patients with benign conditions (143/1243; 11,5 %). The likelihood of suffering from a malignant disease was in the cohort with a CC 70,5 % compared to the baseline percentage of malignancy of 58,6 % in all 3000 patients. With a CC - volume of 800 µl the likelihood of malignancy goes up from 70,5 % to 94,1 % starting at a volume of 1000 µl. The calculation of the relative risk showed that the finding of a CC larger than 1000 µl increases the risk for malignancy by a factor of 1,7 (p = 0,0017).
LizenzStandard (Fassung vom 01.10.2008)
Tomography, x-ray computed
Freie SchlagwörterCisterna chyli