Premium
Computed tomographic lymphangiography of the thoracic duct by subcutaneous iohexol injection into the metatarsal region
Author(s) -
Kim Kitae,
Cheon Sangkyung,
Kang Kyuyong,
Hwang Yawon,
Oh Dayoung,
Yoon Junghee,
Choi Mincheol
Publication year - 2020
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.13324
Subject(s) - medicine , iohexol , thoracic duct , chylothorax , computed tomographic , nuclear medicine , subcutaneous injection , hounsfield scale , radiology , computed tomography , lymphatic system , surgery , pathology , renal function
Objective To evaluate the efficacy of subcutaneous iohexol injection into the metatarsal region for thoracic duct lymphangiography in dogs and to determine the minimum effective dose. Study design Experimental study and clinical report. Animals Five healthy beagle dogs and one dog with chylothorax. Methods For the experimental study, iohexol was injected subcutaneously into the metatarsal region of five dogs at three doses (0.5, 0.75, and 1 mL/kg), and the injection sites were massaged gently. Computed tomography (CT) was performed 1, 3, 5, 7, 10, 15, and 20 minutes after iohexol injection. Subjective quality was assessed, and Hounsfield unit values were measured at several regions of interest (T1, T4, T8, T13, and L3). In the dog with chylothorax, iohexol (1.0 mL/kg) was injected into the right metatarsal region prior to CT. Results The thoracic duct was visualized and enhanced by contrast in all dogs after injection of 0.75 and 1.0 mL/kg of iohexol, and in two dogs after injection of 0.5 mL/kg at 3, 5, and 7 minutes. The thoracic duct was gradually attenuated with increasing doses of iohexol. In the dog with chylothorax, the entire thoracic duct was well enhanced and dilated, and tortuous cranial mediastinal lymphatics were detected. Conclusion The thoracic duct was visualized when at least 0.75 mL/kg of iohexol was injected subcutaneously into the metatarsal region of dogs. Clinical significance Subcutaneous injection of iohexol into the metatarsal region offers a simple alternative to conventional thoracic duct lymphangiography.