【摘要】 目的 探讨CT淋巴管造影(CTL)对胸导管末端成形术治疗乳糜胸短期疗效的术前评估价值。方法 回顾性分析207例乳糜胸患者的临床和CTL表现,其中134例行胸导管末端成形术。由2名放射科医生分析:(1)乳糜胸的侧别、量、分布类型、表现形式。(2)胸导管的数目、主干管腔改变、梗阻部位、梗阻类型。(3)胸水量的变化。采用方差分析评估胸导管末端成形术治疗不同原因乳糜胸的疗效差异,采用多因素Logistic回归筛选影响手术疗效的独立因素,并行受试者工作特征曲线(ROC曲线)分析。结果 胸导管末端成形术治疗不同原因乳糜胸的疗效无差异(P=0.946);胸导管的梗阻部位和乳糜胸的表现形式是影响手术疗效的独立因素,ROC曲线预测概率的准确性为0.668。结论 CTL能够为胸导管末端成形术治疗乳糜胸提供影像学依据,并对手术疗效进行术前评估。更多还原

【Abstract】 Objective To explore the imaging pre-operation evaluation values of CT lymphangiography(CTL) about short-term effect in treatment of chylothorax by thoracic duct extremity(TDE) plasty.Methods A retrospective review of the clinical and radiological data of 207 patients with chylothorax.134 patients underwent TDE plasty.The findings of CTL were analyzed by 2 radiologists,including:(1)Side,amount,distribution pattern,manifestation pattern of chylothorax.(2) Number,luminal change,obstruction position,obstruction pattern of thoracic duct(TD).(3) Amount change of chylothorax.Variance analsis was used to evaluate the difference of short-term effect in different groups in treatment of chylothorax by TDE plasty.Logistic regression was used to screen the independent factor to influence the effect of TDE plasty,and ROC curve was analyzed.Results There was no difference of effect in different groups in treatment of chylothorax by TDE plasty(P=0.946).Obstruction position of TD and manifestation pattern of chylothorax were the prognostic indicators,and the predictive probability value was 0.668.Conclusion CTL can provide imaging information for TDE plasty in treatment of chylothorax,and help to predict the effect of operation.更多还原