Morphology of the distal thoracic duct and the right lymphatic duct in different head and neck pathologies: an imaging b
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RESEARCH
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Morphology of the distal thoracic duct and the right lymphatic duct in different head and neck pathologies: an imaging based study Ferdinand J. Kammerer*, Benedikt Schlude, Michael A. Kuefner, Philipp Schlechtweg, Matthias Hammon, Michael Uder and Siegfried A. Schwab
Abstract Background: The purpose of this study was to assess the influence of head and neck pathologies on the detection rate, configuration and diameter of the thoracic duct (TD) and right lymphatic duct (RLD) in computed tomography (CT) of the head and neck. Methods: One hundred ninety-seven patients were divided into the subgroups "healthy", "benign disease" and "malignant disease". The interpretation of the images was performed at a slice thickness of 3 mm in the axial and coronal plane. In each case we looked for the distal part of the TD and RLD respectively and subsequently evaluated their configuration (tubular, sacciform, dendritic) as well as their maximum diameter and correlated the results with age, gender and diagnosis group. Results: The detection rate in the study population was 81.2 % for the TD and 64.2 % for the RLD and did not differ significantly in any of the subgroups. The predominant configuration was tubular. The configuration distribution did not differ significantly between the diagnosis groups. The mean diameter of the TD was 4.79 ± 2.41 mm and that of the RLD was 3.98 ± 1.96 mm. No significant influence of a diagnosis on the diameter could be determined. Conclusions: There is no significant influence of head/neck pathologies on the CT detection rate, morphology or size of the TD and RLD. However our study emphasizes that both the RLD and the TD are detectable in the majority of routine head and neck CTs and therefore reading physicians and radiologists should be familiar with their various imaging appearances. Keywords: Head and neck pathologies, Distal thoracic duct, Right lymphatic duct, Computed tomography
Background Computed tomography (CT) is a frequently used imaging method for pathologies of the head and neck, which represents a quite complex anatomic region. Various anatomic structures such as arteries or veins have to be differentiated and assessed by the reading physician, for both pure diagnostic purposes and/or therapy planning. As a CT of the head and neck region usually encloses parts of the upper mediastinum, both the distal thoracic duct (TD) and the right lymphatic duct (RLD) are included in the * Correspondence: [email protected] Institute of Radiology, University Erlangen-Nuremberg, Maximiliansplatz 1, D-91054 Erlangen, Germany
examinations as well and are detectable by CT [1]. The function of these main lymphatic vessels is to drain the whole body’s lymphatic fluid into the venous system: the right side of the thorax, the right arm and the right side of the head and neck are drained by the RLD into the junction of the right internal jugular and the right subclavian vein. The TD drains the rest of the body into the junction of the left internal jugular and the left
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