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Normal CT Appearance of the Distal Thoracic Duct

Ming-Eng Liu1, Barton F. Branstetter, IV1,2, Joseph Whetstone1 and Edward J. Escott1

1 Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St., PUH Rm. D132, Pittsburgh, PA 15213.
2 Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213.


Figure 1
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  		Fig. 1 —Contrast-enhanced CT scan of lower part of neck in 28-year-old woman shows tubular configuration of distal thoracic duct (arrows).

 

Figure 2
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  		Fig. 2 —Contrast-enhanced CT scan of lower part of neck in 28-year-old woman shows ampullar flaring of terminal distal thoracic duct (arrows) just before its confluence with venous system.

 

Figure 3
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  		Fig. 3 —Contrast-enhanced CT scan of lower part of neck in 52-year-old woman shows segmental fusiform configuration of distal thoracic duct. Short segment of dilation (arrows) just before venous confluence is evident.

 

Figure 4
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  		Fig. 4A — Thoracic duct presumably opacified by resorption of extravasated IV contrast material in left arm of 62-year-old man. Unenhanced CT scan of lower part of neck shows normal course of thoracic duct (arrow). Duct runs behind common carotid artery (c) toward venous angle in lower left aspect of neck.

 

Figure 5
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  		Fig. 4B — Thoracic duct presumably opacified by resorption of extravasated IV contrast material in left arm of 62-year-old man. Unenhanced CT scan of upper part of chest shows normal course of thoracic duct (arrow) adjacent to esophagus (e).

 

Figure 6
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  		Fig. 5 —71-year-old man with gastric carcinoma. Contrast-enhanced CT scan of lower neck shows Virchow's node as rounded mass (arrows) in medial supraclavicular region, compressing internal jugular vein. Compared with flared configuration of distal duct in Figure 2, lymph node is ovoid mass, whereas duct is tubular with distal flared terminal portion.

 

Figure 7
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  		Fig. 6 —Contrast-enhanced CT scan at thoracic inlet in 56-year-old woman shows dilated vertebral vein (arrows). Vein mimics distal thoracic duct on this image, but vein courses immediately posterior to expected location of duct and extends superiorly on adjacent images.

 

Figure 8
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  		Fig. 7 —Contrast-enhanced CT scan through distal brachiocephalic vein in 28-year-old man shows inflow artifact. Unopacified blood (arrows) from left arm mimics flared distal thoracic duct.

 

Figure 9
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  		Fig. 8A —Normal MR appearance of cervical thoracic duct in 41-year-old woman. T2-weighted axial image through thoracic inlet shows normal course of distal thoracic duct (arrows). High T2 signal intensity is characteristic.

 

Figure 10
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  		Fig. 8B —Normal MR appearance of cervical thoracic duct in 41-year-old woman. T2-weighted axial image through thoracic inlet shows termination of distal thoracic duct (arrows). High T2 signal intensity is characteristic.

 

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