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Published online by Cambridge University Press: 07 October 2011
Imaging description
The cysterna chyli is a lymphatic sac formed by the confluence of lumbar lymphatic ducts. It is the origin (caudal-most aspect) of the thoracic duct [1]. It is in the right retrocrural space usually at the T11–L2 level [1]. The confluence of the lumbar lymphatic channels occasionally (1.7%) will form a distinct tubular structure on CT [2] and can appear as a round or elliptical opacity 4–9 mm (average 7 mm) in size [2]. On CT it has attenuation similar to that of water [1, 2] (Figure 72.1). On MRI it has signal intensity similar to that of bile or cerebrospinal fluid [3] and can have many different shapes including round, oval, sausage-shaped, or a focal plexus [3].
Importance
A prominent cysterna chyli can simulate a low-attenuation enlarged lymph node or focal retrocrural fluid collection.
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