Visualization and prediction of the pleura and thoracic duct: elucidation of changes due to respiration using arterial landmarks and CT images.

IF 1.4 4区医学 Q2 Medicine Surgical and Radiologic Anatomy Pub Date : 2025-02-07 DOI:10.1007/s00276-025-03582-3

Niina Hirano, Satoru Muro, Junichi Tsuchiya, Keiichi Akita

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引用次数: 0

Abstract

Purpose: The thoracic duct uses the pulsation of accompanying arteries to facilitate lymphatic flow. However, the lymphatic flow mechanism cannot be explained when it does not accompany the arteries. This study aimed to clarify the anatomical position of the thoracic duct and surrounding structures and determine the differences in the thoracic duct length and course during inspiration and expiration.

Methods: Six cadavers were dissected to observe the positional relationship between the thoracic duct and surrounding structures. Image sequences of anatomical sections from the Visible Korean Human Open Resource were observed and reconstructed to understand their three-dimensional positioning. Inspiratory and expiratory computed tomography scans were used to measure and examine respiratory variations in the distance between the arterial landmarks to predict the thoracic duct length.

Results: The thoracic duct accompanied the arteries for most of its course and was sandwiched between the arteries and pleura, entering the mediastinum. However, there was an area on the cranial side of the aortic arch where the thoracic duct did not accompany the arteries. The distance between the arterial landmarks in this area, which approximate the thoracic duct length, was significantly longer during inspiration (39.3 ± 7.81 mm) than during expiration (31.49 ± 7.01 mm).

Conclusion: This study suggests that the pleura entering the mediastinum pushes the thoracic duct toward the arteries to promote lymphatic flow generation by arterial pulsation. Additionally, this study suggests that the lymphatic flow in the thoracic duct is generated by the expansion and contraction of the thoracic duct with respiratory movement.

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.