Lymphatic Imaging: Current Noninvasive and Invasive Techniques

Schwartz, Fides R.; James, Olga; Kuo, Phillip H.; Witte, Marlys H.; Koweek, Lynne M. Hurwitz; Pabon‐Ramos, Waleska M.

doi:10.1055/s-0040-1713441

Cited by 20 publications

(14 citation statements)

References 37 publications

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“…The route of EPO is easily visualizable under fluoroscopy, but lymphangiography is a time-intense procedure, as the EPO flows very slowly in the lymphatic channels. Use of EPO should be avoided in patients with a history of sensitivity to other iodinated contrast agents because of an increased risk of a hypersensitivity reaction to Lipiodol [36][37][38]. Hypersensitivity reactions to Lipiodol can occur within half an hour and up to several days after administration, although as mentioned, none occurred in this cohort.…”

Section: Discussionmentioning

confidence: 67%

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

et al. 2021

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Background: There is a sparsity of data on the use of ethiodized poppy seed oil (EPO) contrast agent (Lipiodol) in patients. We investigated the safety of EPO in children, adolescents, and some adults for diagnostic and therapeutic interventions. Methods: All patients who underwent procedures with EPO between 1995 and 2014 were retrospectively included. Demographic characteristics, diagnosis, dose, route of administration, preparation of EPO in combination with other agents, and complications were recorded. Results: In 1422 procedures, EPO was used for diagnostic or treatment purposes performed in 683 patients. The mean patient age was 13.4 years (range: 2 months–50 years); 58% of patients were female. Venous malformations (n = 402, 58.9%) and arteriovenous malformations (n = 60, 8.8%) were the most common diagnosis. Combined vascular anomalies included capillary–lymphatic–venous malformations, fibroadipose vascular anomalies (n = 54, 7.9%), central conducting lymphatic anomalies (n = 31, 4.5%), lymphatic malformations (n = 24, 3.5%), aneurysmal bone cysts (n = 22, 3.2%), and vascularized tumors (n = 11, 1.6%). In 1384 procedures (96%), EPO was used in various combinations with sclerosing and embolization agents, including sodium tetradecyl sulfate, ethanol, and glue. The mean volume of EPO used in interventions was 3.85 mL (range: 0.1–25 mL) per procedure with a mean patient weight of 45.9 kg (range: 3.7–122.6 kg) and a weight-adjusted dose of 0.12 mL/kg (range: 0.001–1.73 mL/kg). In 56 procedures (4%), EPO was used as a single agent for diagnostic lymphangiography. The mean volume was 4.8 mL (range: 0.3–13 mL) per procedure with a mean patient weight of 27.4 kg (range: 2.4–79.3 kg) and a weight-adjusted dose of 0.2 mL/kg (range: 0.04–0.54 mL/kg). Procedural-related complications occurred in 25 (1.8%) procedures. The 20 minor and 5 major complications were related to the primary treatment agents. None of them were directly related to EPO. No allergic reactions were noted. Conclusion: The use of an ethiodized poppy seed oil contrast agent in children, adolescents, and adults for diagnostic or therapeutic purposes is safe.

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Section: Discussionmentioning

confidence: 67%

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

et al. 2021

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“…Sequential or continuous images are acquired immediately after injection. Delayed images may be obtained from 1 to 3 hours or even longer following injection, depending on the purpose of the study [ 14 ]. The radiation dose is relatively low, and there are no known risks.…”

Section: Imaging Of the Lymphatic Systemmentioning

confidence: 99%

“…The lymphatic channel is cannulated with a 30-gauge needle, and a silk suture is tied around the needle and cannulated to secure the needle in place. An automated injector filled with Lipiodol (Guerbet) was then connected to the needle and set to the following injection protocol: injection rate, 8–12 mL/hour; total injection volume, 10 mL per extremity; and pressure, 150 psi [ 14 ]. A low injection speed should be maintained to prevent rupture of the lymphatic channel, which can result from forceful injection.…”

Section: Imaging Of the Lymphatic Systemmentioning

confidence: 99%

Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part I. History, Anatomy, Physiology, and Diagnostic Imaging of the Lymphatic System

et al. 2023

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Recent advances in lymphatic imaging have provided novel insights into the lymphatic system. Interventional radiology has played a significant role in the development of lymphatic imaging techniques and modalities. Radiologists should be familiar with the basic physiology and anatomy of the lymphatic system to understand the imaging features of lymphatic disorders, which reflect their pathophysiology. This study comprehensively reviews the physiological and anatomical aspects of the human lymphatic system as well as the latest lymphatic imaging techniques.

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“…64 Lymphangioscintigraphy or lymphangiography are used to identify the anatomy and location of a leak. 65 Lymphangiography with lipiodol has the added benefit of being reported to effectively seal chyle leaks in 50 to 75% of cases, depending on the rate of output, potentially through the slowing of lymphatic flow or localized inflammation. 63,66 When the thoracic duct and cisterna chyli can be visualized and accessed percutaneously, embolization with glue and coils is appropriate.…”

Section: Posttraumatic Lymphatic Complications Lymphatic Leakmentioning

confidence: 99%

Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

Wolf

Smolinski-Zhao

2021

Semin intervent Radiol

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In addition to acute injury requiring interventional radiologic treatments, patients with traumatic injuries can develop delayed or chronic complications. These injuries can involve nearly all solid organs in the abdomen. Coupled with significant improvements in visualizing these injuries with advanced imaging techniques such as minimally invasive procedures, nonoperative management of both acute traumatic injuries and their longer term sequelae has become the norm. This article reviews frequently seen complications of traumatic injury and their management by interventional radiologists.

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Lymphatic Imaging: Current Noninvasive and Invasive Techniques

Cited by 20 publications

References 37 publications

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part I. History, Anatomy, Physiology, and Diagnostic Imaging of the Lymphatic System

Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

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