Chyluria: non-enhanced MR lymphography

Insights into Imaging

Educational Review

Lionel Arrivé¹  Lise Minssen¹  Alexandre Sabbah¹  Sanaâ El Mouhadi¹  Quentin Vanderbecq¹  Amal Ali¹  Cedi Koumako¹ 

[1] Department of Radiology, Saint-Antoine Hospital, Assistance Publique – Hôpitaux de Paris (APHP) and Sorbonne University, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France;

关键词: Chyluria;    Lymphatics;    Filariasis;    MR imaging;    MR lymphography;   

DOI  :  10.1186/s13244-023-01461-2

 received in 2023-04-26, accepted in 2023-06-07,  发布年份 2023

来源: Springer

【 摘 要 】

Chyluria is an uncommon medical condition resulting from an abnormal communication between the abdominal lymphatic system and the urinary tract, which results in the presence of chyle in the urine, making it appear milky white. Proper diagnosis is demonstrated by the concentration of urinary lipids. Worldwide, chyluria is most commonly associated with the parasite Wuchereria bancrofti. However, in Europe and North America, where the condition is rare, non-parasitic etiologies predominate. Identifying the cause and location of the uro-lymphatic communication is essential in guiding therapeutic management, but imaging the lymphatic channels remains a challenge. Magnetic resonance (MR) lymphography, a non-invasive free-breathing 3D high-resolution fast-recovery fast spin-echo sequence similar to that used for 3D MR cholangiopancreatography, may demonstrate the cause and location of an abnormal communication between the lymphatic system and urinary tract. In parasitic causes of chyluria, dilated lymphatics vessels communicating with the lymphatic system are demonstrated. In non-parasitic causes of chyluria channel type lymphatic malformations are the most common. Markedly dilated and dysplastic lymphatic vessels communicating with the urinary tract are demonstrated. In addition, other cystic or channel type lymphatic malformations such as thoracic, soft tissue or bone abnormalities may be observed. This review describes the abdominal lymphatic diseases leading to chyluria and presents the technique and images obtained with non-enhanced MR lymphography to enable radiologists in identifying and classifying uro-lymphatic fistulae.Critical relevance statement: Non-enhanced MR lymphography enables the identification and categorization of uro-lymphatic fistulae.Graphical abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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