Cisterna chyli

Zystoide,
etwas spindelförmige Formation rechts neben der Aorta am Zwerchfelldurchtritt, bei der es sich sehr wahrscheinlich um die Cisterna chyli handelt. Sie setzt sich nach oben in den Ductus thoracicus fort. Sieht man zwar nicht oft so deutlich, ist aber dennoch eine normale anatomische Struktur und sollte nicht mit retrocruralen Lymphknoten verwechselt werden.
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Cisterna
chyli als Nebenbefund bei einer LWK-1-Fraktur an typischer Stelle rechts paraaortal auf Höhe BWK 12 am Zwerchfelldurchtritt.
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Cisterna
chyli und Ductus thoracicus
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Cisterna
chyli
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Cisterna
chyli
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Cisterna
chyli und Venen embryonal
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The relations
of the viscera and large vessels of the abdomen. (Seen from behind, the last thoracic vertebra being well raised.)
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"83 male had
a CT for follow-up of gastrointestinal stromal tumour. A low-density structure (arrow) is seen in a right retrocrural location, adjacent to the azygous vein (curved arrow). While this might be mistaken for lymphadenopathy, it could be followed superiorly to a thin vascular structure in the posterior mediastinum. The retrocrural structure represents the cisterna chyli, and its continuation in the thorax is the thoracic duct. Not normally seen on CT, it is however a normal structure, and should be recognised as such." (dr Dawes)
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Radiopaedia • CC-by-nc-sa 3.0 • de

The cisterna chyli (CC) (plural cisternae chyli), also known as the receptaculum chyli, is a normal anatomical structure in the lymphatic system. It is seen as a saccular area of dilatation in the lymphatic channels that are located in the retrocrural space, usually to the immediate right of the origin of the abdominal aorta.

Gross anatomy

Location

The cisterna chyli is located at the level of L1 and L2 vertebral bodies immediately right to the aorta behind the right crus of the diaphragm.

Origin

It is an elongated, sac-like structure formed by the junction of a variable number of lumbar, intestinal, liver and descending intercostal lymphatic trunks. It extends 5-7 cm in the caudocephalad axis, but the size varies greatly with patient position.

Termination

The upper end of the cisterna chyli continues as the thoracic duct which ascends in the posterior mediastinum to empty into the left subclavian vein.

Drainage

Receives lymph from the abdominal viscera as well as the abdominal wall (below the level of the umbilicus), non-alimentary viscera and lower extremities.

Relations
  • anterior: right crus of the diaphragm
  • posterior: L1 and L2 vertebral bodies
  • left lateral: abdominal aorta
  • right lateral: azygos vein

Radiographic features

CT

The cisterna chyli can be identified as a rounded-to-elliptical retrocrural structure with an average attenuation of 4 HU. There is no enhancement following intravenous contrast administration.

MRI

The signal intensity characteristics of the cisterna chyli on MRI are the same as those for static or slow-moving fluids with high signal intensity on fluid-sensitive MR sequences .

Differential diagnosis

On CT consider:

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Cisterna chyli:
Ductus
thoracicus
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neuroenterische
Zyste
pediatricimaging.org • CC-by-nc-sa 4.0