KRONİK KARACİĞER HASTALIĞINDA SİSTERNA ŞİLİ ÇAPININ MANYETİK REZONANS GÖRÜNTÜLEME İLE DEĞERLENDİRİLMESİ

Amaç: Sisterna şili retrokrural alanda, aortanın sağında, lomber1 ve lomber2 vertebra seviyesinde yerleşim gösteren, lenfatik bir kanaldır. Otozomal dominant polikistik böbrek hastalığı, portal hipertasiyon, kalp yetmezliği gibi çeşitli hastalıklarda sisterna şili çapında artışın olduğu ve bu artışın manyetik rezonans görüntüleme (MRG) ile gösterilebileceğini belirten çalışmalar yer almaktadır. Çalışmamızın amacı kronik karaciğer hastalığında sisterna şilide oluşabilecek çap değişikliklerini tespit edebilmek ve çapdaki olası artışının MRG’de tanısal görüntüleme bulgusu olarak kullanılabilirliğini araştırmaktır. ve sistematik otopsi verilerinin değerlendirilmesi amaçlanmıştır. Materyal ve Metot: Bu çalışmaya 33 kronik karaciğer hastası ve 56 kontrol grubu dahil edildi. Her iki grupta da single-shot fast spin-echo tekniği ile elde edilmiş, ağır T2 ağırlıklı aksiyal kesitlerde sisterna şilinin en geniş transvers çapı 1,5 Tesla MRG cihazı kullanılarak ölçüldü. Sisterna şili çapı kronik karaciğer hastalığı olan grupla sağlıklı grup arasında iki ortalama arasındaki farkın önemlilik testi ile karşılaştırıldı. Kronik karaciğer hastalığını ortaya koymada farklı sisterna şili eşik değerlerinin etkinliğini tespit etmek için receiver operating characteristic (ROC) eğrisi oluşturuldu. Bulgular: Ortalama sisterna şili çapı hasta grupta 4,91±1,5 mm, kontrol grubunda 4,31±1,12 mm saptanmış olup hasta grupta istatistiksel açıdan anlamlı olacak şekilde daha genişti (p4,4 mm olarak belirlendi. Sonuç: Sisterna şili çapı kronik karaciğer hastalığında normal populasyona göre daha dilate izlenmektedir ve dilate sisterna şili diğer görüntüleme bulgularını destekleyici olarak, kronik karaciğer hastalığının varlığını gösteren bir MRG belirteci olarak kullanılabilir.

EVALUATION OF CISTERNA CHYLI DIAMETER WITH MAGNETIC RESONANCE IMAGING IN CHRONIC LIVER DISEASE

Aim: Cisterna chyli is a lymphatic duct located in the retrocural area at the right side of the aorta. There are studies reporting an increase in the diameter of the cisterna chyli in various diseases such as autosomal dominant polycystic kidney disease, portal hypertension and heart failure which can be demonstrated by magnetic resonance imaging (MRI). The aim of this study is to determine the possible changes in the diameter of the cisterna in chronic liver disease and to evaluate the possible increase in the diameter as a diagnostic imaging finding in MRI., Materials and Methods: 33 chronic liver patients and 56 healthy controls (HC) were included in this study. In both groups, the largest transverse diameter of the cisterna was measured on heavy T2-weighted axial sequences obtained with single-shot fast spin-echo technique by using 1.5 Tesla MRI device. The cisterna chyli diameter in patients with chronic liver diesease was compared to HC group. A receiver operating characteristic (ROC) curve was created to determine the effectiveness of different cisterna chyli thresholds in revealing chronic liver disease. Results: The mean cisterna chyli diameter was 4,91 ± 1,5 mm in the patient group and 4,31 ± 1,12 mm in the control group, and it was wider in the patient group and statistically significant (p 4.4 mm with a sensitivity of 0,606 and a specificity of 0,768. Conclusion: The cisterna chyli diameter is more dilated in chronic liver disease than in the normal population, and dilated cisterna chyli may be used as a marker of MRI indicating chronic liver disease, supporting other imaging findings.

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