■心包是指心包腔中乳糜液的积聚。非增强磁共振淋巴管造影(MRL)可显示原发性乳糜心包的颈部和胸部淋巴异常。目前尚不清楚原发性乳糜心包和胸导管末端松解术中颈部和胸部淋巴异常之间是否存在关系。本研究旨在探讨在非增强MRL中观察到的颈部和胸部淋巴异常的严重程度与原发性乳糜心包手术结果之间的相关性。
■这是一项回顾性队列研究。回顾性分析2016年1月至2021年12月诊断为原发性乳糜心包的56例患者,所有患者均行胸导管末端松解术。超声检查,在手术干预前进行胸部计算机断层扫描(CT)和非增强MRL检查.根据在非增强MRL中观察到的颈部和胸部淋巴异常的严重程度,将患者分为四种类型。使用χ2检验或Fisher精确检验比较不同类型的临床和实验室检查和手术结果,t检验,和Kruskal-WallisH检验.此外,分析影响手术结局的独立因素.
■在原发性乳糜心包病例中(n=56),22(39.2%)被分类为I型或II型,17(30.4%)为III型,和17(30.4%)为IV型。I型或II型患者的手术结果比III型或IV型患者更有利,伴有术后原发性乳糜心包体积减少(P=0.002)。术后胸部CT扫描显示,I型或II型患者出现大网格阴影的实例较少,小网格阴影,与术前扫描相比,支气管血管束增厚(P=0.001,P=0.02,P=0.03)。年龄和支气管舒张干扩张是影响手术结局的独立因素[比值比(OR)0.03,95%置信区间(CI):0.003-0.220,P=0.001;OR11.10,95%CI:1.70-72.39,P=0.01]。
■更严重程度的颈部和胸部淋巴异常与更差的手术结果相关。此外,年龄和支气管纵隔干扩张是手术结局的独立预测因素.术前利用非增强型MRL对原发性乳糜心包患者的淋巴异常分类的严重程度提供了评估手术风险的非侵入性手段。
UNASSIGNED: Chylopericardium refers to the accumulation of chylous fluid in the pericardial cavity. Non-enhanced magnetic resonance lymphangiography (MRL) can show neck and thoracic lymphatic abnormalities in the primary chylopericardium. It is not clear whether there is a relationship between neck and thoracic lymphatic abnormalities in primary chylopericardium and thoracic duct terminal release surgery. This study aimed to explore the correlation between the severity of neck and thoracic lymphatic abnormalities observed in non-enhanced MRL and the surgical outcomes in primary chylopericardium.
UNASSIGNED: This is a retrospective cohort study. A retrospective analysis was conducted on fifty-six patients diagnosed with primary chylopericardium between January 2016 and December 2021, all of whom underwent thoracic duct terminal release surgery. Ultrasonography, chest computed tomography (CT) and non-enhanced MRL were performed prior to the surgical intervention. Patients were categorized into four types based on the severity of neck and thoracic lymphatic abnormalities observed in the non-enhanced MRL. Clinical and laboratory examinations and surgical outcomes were compared across different types using χ 2-test or Fisher\'s exact test, t-test, and Kruskal-Wallis H-test. Additionally, independent factors influencing surgical outcomes were analyzed.
UNASSIGNED: Among primary chylopericardium cases (n=56), 22 (39.2%) were classified as type I or II, 17 (30.4%) as type III, and 17 (30.4%) as type IV. Surgical outcomes were more favorable for type I or II patients than those with type III or IV, accompanied by a reduction in postoperative primary chylopericardium volume (P=0.002). Postoperative chest CT scans indicated that type I or II patients had fewer instances of large grid shadows, small grid shadows, and bronchovascular bundle thickening compared to preoperative scans (P=0.001, P=0.02, P=0.03). Age and bronchomediastinal trunk dilation emerged as independent factors influencing surgical outcomes [odds ratio (OR) 0.03, 95% confidence interval (CI): 0.003-0.220, P=0.001; OR 11.10, 95% CI: 1.70-72.39, P=0.01, respectively].
UNASSIGNED: A more severe degree of neck and thoracic lymphatic abnormalities is associated with worse surgical outcomes. Moreover, age and bronchomediastinal trunk dilatation are independent predictors of surgical outcomes. Preoperative utilization of non-enhanced MRL for severity of lymphatic abnormalities classification in primary chylopericardium patients offers a noninvasive means of assessing surgical risk.