Evaluation of cisterna chyli diameter with MRI in patients with chronic kidney disease

• Published in: Journal of magnetic resonance imaging 2016-10, Vol.44 (4), p.890-896
• Main Authors: Albayrak, Eda, Ozmen, Zafer, Sahin, Safak, Demir, Osman, Erken, Ertugrul
• Format: Article
• Language: English
• Subjects: chronic kidney disease; cisterna chyli; Female; Humans; Image Interpretation, Computer-Assisted - methods; lymphatics; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; MRI; Renal Insufficiency, Chronic - diagnostic imaging; Renal Insufficiency, Chronic - pathology; Reproducibility of Results; Sensitivity and Specificity; Thoracic Duct - diagnostic imaging; Thoracic Duct - pathology
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.25249

Purpose To evaluate cisterna chyli (CC) diameter with magnetic resonance imaging (MRI) in patients with chronic kidney disease (CKD). Materials and Methods The study included 71 patients with CKD and 68 healthy controls. In both groups, the largest transverse diameter of CC was measured in axial heavily T2‐weighted images using a 1.5T MRI. The diameter of the CC in the CKD patients and control group were compared, and the correlations between the CKD, glomerular filtration rate (GFR), and stage of CKD were investigated. The CC diameters were compared between/among groups with independent sample t‐test or one‐way analysis of variance (ANOVA). A receiver operating characteristic (ROC) curve was constructed for CC diameter to determine the effectiveness of various cutoff points for the presence of CKD. The Pearson correlation coefficient was used to examine correlation between CC diameter and GFR. Multivariate logistic regression models were implemented in order to examine to determine relation among selected variables and study group. Results The average CC diameter was 5.68 ± 2.55 mm in the CKD group, and 3.18 ± 2.24 mm in control group (P < 0.001). The CC diameter showed an increase with more severe stages of the disease (P < 0.001). There was a significant negative correlation between CC diameter and GFR (r –0.447, P < 0.001). Based on multivariate analysis, it was determined that the only factor associated with severity of disease was CC diameter (odds ratio: 1.636, 95% confidence interval: 1.314–2.037, P < 0.0001). Based on ROC analysis, the optimal CC diameter cutoff value for detecting CKD was 4.5 mm, with sensitivity and specificity values of 0.704 and 0.824, respectively. Conclusion CC diameter is observed to be larger in patients with CKD than in the normal population. Additionally, CC diameter increased with more severe stages of CKD. According to our results, CC diameter might be used as an MRI marker to indicate the presence and severity of CKD. J. MAGN. RESON. IMAGING 2016;44:890–896.