Ultrasound analysis of cervical thoracic duct for patients with constrictive pericarditis and chylothorax

• Published in: Journal of clinical ultrasound 2024-06, Vol.52 (5), p.529-534
• Main Authors: Wang, Yingying, Zheng, Binyu, Zhao, Xiaoning, Chen, Qi, Yi, Mei, Wen, Zhe, Liu, Yong
• Format: Article
• Language: English
• Subjects: Adult; Aged; cervical thoracic duct; chylothorax; Chylothorax - diagnostic imaging; constrictive pericarditis; Female; Humans; Male; Middle Aged; Parameters; Pericarditis; Pericarditis, Constrictive - complications; Pericarditis, Constrictive - diagnostic imaging; Pericarditis, Constrictive - physiopathology; Pleural effusion; Regurgitation; Retrospective Studies; Reversed flow; Thoracic duct; Thoracic Duct - diagnostic imaging; Ultrasonic imaging; Ultrasonography - methods; Ultrasound
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.23671

Purpose To analyze ultrasound features of cervical thoracic duct for patients with constrictive pericarditis and chylothorax. Methods Patients were retrospectively assessed. The patients were divided into a non‐pleural effusion (PE) group (n = 54), a chylothorax group (n = 23), and non‐chylothorax group (n = 28). Conventional ultrasound was used to obtain the maximum inner diameter and collapse of the inferior vena cava, the inner diameter of left cervical thoracic duct, and the frequency of opening of the valve at the end of the left thoracic duct. Contrast ultrasonography was used to score the reverse flow of the thoracic tube. Results The percentage of PE was 48.5%, and the percentage of chylothorax was 21.9%. The three groups had significant differences in five parameters. The inner diameter of left cervical thoracic duct was correlated with the degree of central venous pressure. Contrast ultrasonography was effective in quantitative assessment of the degree of intravenous‐thoracic cord reverse flow which correlated with all parameters of central venous pressure. Conclusion Thoracic duct dilation and regurgitation secondary to central venous pressure can lead to chyloreflux disorder and may be the mechanism of chylothorax occurrence in constrictive pericarditis. We used ultrasound to observe cervicothoracic duct morphology and chyloreflux, and analyzed the correlation between them. We conclude that thoracic duct dilation and regurgitation secondary to central venous hypertension may lead to impaired chyloreflux and may be the mechanism of chylothorax in patients with constrictive pericarditis.