Dynamic contrast enhanced magnetic resonance lymphangiography: Categorization of imaging findings and correlation with patient management

Pimpalwar, Sheena; Chinnadurai, Ponraj; Chau, Alex; Pereyra, Mercedes; Ashton, Daniel J.; Masand, Prakash; Krishnamurthy, Rajesh; Jadhav, Siddharth P.

doi:10.1016/j.ejrad.2018.02.021

Cited by 42 publications

(21 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13,14 We did not perform extensive preprocedural imaging but especially for PB imaging techniques such as inguinal node lymphangiography and dynamic contrast enhanced magnetic resonance lymphangiography may assist in planning and selecting ideal patients for selective lymphatic duct embolization. [35][36][37]…”

Section: Discussionmentioning

confidence: 99%

Percutaneous embolization of lymphatic fistulae as treatment for protein‐losing enteropathy and plastic bronchitis in patients with failing Fontan circulation

Maleux

Storme

Cools

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Background To determine the feasibility and clinical result of selective embolization of hepatoduodenal or paratracheal lymphatics in Fontan patients with protein‐losing enteropathy (PLE) or plastic bronchitis (PB). Methods Dilated lymph vessels in periportal (PLE) or paratracheal (PB) position were percutaneously punctured with a 22G Chiba needle. Intralymphatic position was confirmed by water soluble contrast injection with drainage to hepatoduodenal or tracheal fistulae. After flushing with 10% glucose solution, occlusion of hepatoduodenal or paratreacheal lymphatics was effected by injection of 1–4 cc mixture 4/1 of Lipiodol/n‐butyl cyanoacrylate (n‐BCA; Histoacryl). Results Seven patients with proven PLE were treated with periportal lymphatic embolization 10.7 (range: 6.6–13.5) years after the Fontan operation. The Fontan operation was performed at a median age of 3.7 (range: 2.9–5.7) years and PLE started a median of 3.1 (range: 0.9–4.7) years later. Five patients required a second procedure 2–8 months later. Complications were limited (spillage of glue in portal branch, transient cholangitis, and caustic duodenal bleeding). Six of seven patients reported significant improvement in quality of life and normalization of albumin levels after limited follow‐up (p < .01). One patient (Fontan at 2.9 years; age 16.4 years) had PB for 2 years. Selective transthoracic cone‐beam‐directed puncture of left and right paratracheal lymphatics with n‐BCA embolization of distal lymphatic fistulae resulted in lasting absence of tracheal casts (11 months). Conclusions Embolization of periportal/peritracheal lymphatics is a promising technique in Fontan patients with PLE/PB. Larger series are required to determine incidence and reasons of success/failure, with long‐term results and effects on liver function.

show abstract

Section: Discussionmentioning

confidence: 99%

Percutaneous embolization of lymphatic fistulae as treatment for protein‐losing enteropathy and plastic bronchitis in patients with failing Fontan circulation

Maleux

Storme

Cools

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…Nodal DCE-MRL yields unparalleled visualization of central lymphatic anatomy, function, and lymphatic pathologies. 13,15 However, there are several logistic prerequisites that have to be met, such as a detachable MR table and a sonography unit in close proximity to the MR scanner room. DCE-MRL can also be time consuming due to required patient transfers and inguinal lymph node puncture.…”

Section: Transpedal Magnetic Resonance Lymphangiographymentioning

confidence: 99%

“…9). 15,46,48 This information is critical in adequately planning further treatment. While lymph vessel embolization may be useful in cases with normal thoracic duct to occlude alternate lymphatic pathways, it may be contraindicated in patients suffering primarily from an obstructive process.…”

Section: Lymphatic Flow Pathologiesmentioning

confidence: 99%

“…Recent literature has documented a significant clinical value of MRL for the diagnosis and treatment of patients with central lymphatic disorders forgoing the need of an oily contrast agent. 8,[13][14][15] This review article describes current MRL techniques with a focus on contrast-enhanced MRL techniques, their specific advantages, and possible clinical applications in patients suffering from pathologies of the central lymphatic system.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Nodal and Pedal MR Lymphangiography of the Central Lymphatic System: Techniques and Applications

Pieper

2020

Semin intervent Radiol

View full text Add to dashboard Cite

Novel lymphatic imaging and interventional techniques are increasingly used in the diagnostic workup and treatment of pathologies of the central lymphatic system and have opened a new field of interventional radiology. The mainstay of lymphatic imaging today is magnetic resonance lymphangiography (MRL). It provides information on the anatomy of the central lymphatic system, lymphatic flow, as well as lymphatic pathologies and therefore is a valuable tool for treatment planning. There are two techniques to perform contrast-enhanced MRL: nodal dynamic contrast-enhanced MRL (nodal DCE-MRL) and interstitial transpedal MRL (tMRL). Nodal DCE-MRL yields superior information on lymphatic flow dynamics and is therefore best suited for suspected lymphatic flow pathologies and lymphatic malformations. tMRL is a technically simpler alternative for central lymphatic visualization without the need for sonographically guided lymph node cannulation. This review article describes current MRL techniques with a focus on contrast-enhanced MRL, their specific advantages, and possible clinical applications in patients suffering from pathologies of the central lymphatic system.

show abstract

“…Dynamic contrast-enhanced magnetic resonance lymphangiography has improved the sensitivity of lymphatic leak detection, increased the understanding of lymphatic flow anomalies, and aided in procedural planning for complex lymphatic intervention. 12,13 Successful treatments of pediatric chylothorax, chylous ascites, protein losing enteropathy, and plastic bronchitis are being increasingly described at different medical centers across the world. [14][15][16][17][18][19] These treatments involve novel approaches and utilize techniques that include retrograde transvenous lymphangiography, transcervical lymphangiography, thoracic duct stent-grafting, and balloon occlusion retrograde abdominal lymphangiography, among others.…”

mentioning

confidence: 99%

Lymphatics, Long a Mystery—Primed to Make History

Majdalany

2020

Semin intervent Radiol

View full text Add to dashboard Cite

Dynamic contrast enhanced magnetic resonance lymphangiography: Categorization of imaging findings and correlation with patient management

Cited by 42 publications

References 13 publications

Percutaneous embolization of lymphatic fistulae as treatment for protein‐losing enteropathy and plastic bronchitis in patients with failing Fontan circulation

Percutaneous embolization of lymphatic fistulae as treatment for protein‐losing enteropathy and plastic bronchitis in patients with failing Fontan circulation

Nodal and Pedal MR Lymphangiography of the Central Lymphatic System: Techniques and Applications

Lymphatics, Long a Mystery—Primed to Make History

Contact Info

Product

Resources

About