Modern Techniques of Lymphangiography and Interventions: Current Status and Future Development

Itkin, Maxim; Nadolski, Gregory J.

doi:10.1007/s00270-017-1863-2

Cited by 100 publications

(69 citation statements)

References 49 publications

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“…In addition, it is helpful for planning lymphatic embolization or alternative percutaneous interventions depending on the lymphatic anatomy. [19][20][21] Nadolski et al reported nine patients who underwent DC-MRL in the setting of CA demonstrating lymphatic leakage in seven patients all of which had traumatic etiology. 22 Lymphangiography is an important technique for the detection and treatment of lymphatic leaks.…”

Section: Clinical Complications and Diagnosis Of Chylous Ascitesmentioning

confidence: 99%

“…Different authors have described several percutaneous approaches to treat refractory ascites with different embolic materials. 20,22,24,25,29,30,[46][47][48][49][50][51][52][53][54][55] INL has been accepted as the gold standard invasive imaging test to delineate the anatomy of the lymphatic system and identify the site of leakage, particularly lymphatic leaks arising from the pelvis, retroperitoneum, and central lymphatics (cisterna chyli and TD). Patients with CA after pelvic lymphadenectomy or retroperitoneal lymphadenectomy (RPLDN) are good candidates for INL alone or associated with glue embolization of the lymph node or lymphatic vessels feeding the leak.…”

Section: Pathways For Lymphangiography and Lymphatic Embolization In mentioning

confidence: 99%

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Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

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Kinmonth introduced lymphangiography in 1955 and it became an important tool in the diagnosis and treatment of malignant disease. The technique, based on bipedal approach, was difficult and time-consuming which limited its use in clinical practice. Cope is the father of percutaneous lymphatic interventions and he was the first person to access and intervene on the lymphatic system. After his initial work published on 1999, there has been an expansion of the lymphatic embolization techniques, particularly since the development of intranodal lymphangiography and advance lymphatic imaging. This article is focused on the evaluation and management of postoperative chylous ascites and lymphoceles. Their incidence is growing due to longer survival of cancer patients and more radical surgical approaches, leading to an increased morbidity and mortality in this patient population. Minimally invasive percutaneous lymphatic embolization is becoming a first-line therapy in patients with postoperative lymphatic leakage.

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Section: Clinical Complications and Diagnosis Of Chylous Ascitesmentioning

confidence: 99%

Section: Pathways For Lymphangiography and Lymphatic Embolization In mentioning

confidence: 99%

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Santos

Moussa

2020

Semin intervent Radiol

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“…The intranodal dynamic MRL (Figure ) evaluates the central conducting lymphatics (usually from the pelvic lymphatics to the site of drainage of the thoracic duct). Since its introduction in clinical practice in the last decade, it has played a crucial role in the understanding and management of CLAs.…”

Section: Recommendationsmentioning

confidence: 99%

Multidisciplinary guidelines for initial evaluation of complicated lymphatic anomalies—expert opinion consensus

Iacobas

Adams

Pimpalwar

et al. 2019

Pediatric Blood & Cancer

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Objective Complicated lymphatic anomalies (CLAs) are chronic, progressive, and debilitating conditions that share clinical features, yet key elements for optimal evaluation and management have not been established. We aimed to formulate expert opinion consensus‐based guidelines for comprehensive evaluation of CLAs. Study Design Patient support groups dedicated to CLAs organized an international conference for vascular anomaly experts from 16 specialties to address the objective. Participants received a set of questions before the meeting and reviewed the literature. Data extracted from international lymphatic anomaly registries were presented and the group separated for panel discussions during the conference. The recommendations achieving consensus within the panel were presented to the entire audience. Open debate occurred until majority approval was achieved. Results The expert group was composed of 52 physicians who defined the clinical elements required to evaluate and diagnose a CLA. The radiology panel established the preferred anatomical and functional imaging methods for diagnosis and the elements required to be described during interpretation. Two medical panels compiled the metabolic and hematologic tests at diagnosis and also recommended functional studies. The surgical group recommended precautions for biopsy and the pathology panel provided biopsy specimen processing guidelines. Conclusions Patients with CLAs require a comprehensive and targeted diagnostic plan for appropriate management, prevention of complications, and conservation of resources. As this population is managed by diverse medical and surgical specialties, we offer an expert multidisciplinary consensus‐based opinion on the current literature and on data extracted from international lymphatic anomaly registries.

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“…In both primary and secondary lymphedema of upper and lower limbs, non-contrast magnetic resonance (MR) lymphography has demonstrated its interest for positive diagnosis, evaluation of severity, classification, and follow-up [8,9]. Contrast-enhanced MR lymphangiography may also be performed for analysis of the lymphatic system and is notably useful from a functional point of view (10).…”

Section: Introductionmentioning

confidence: 99%

Non-contrast MR lymphography of the lymphatic system of the liver

et al. 2019

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This review shows the images obtained with non-contrast MR lymphography in different pathologic conditions affecting the liver. Non-contrast MR lymphography is obtained with a free-breathing 3D high spatial resolution fast-recovery fast spin-echo sequence similar to that used for 3D MR cholangiopancreatography. The liver is the largest lymph-producing organ generating approximately half of the body's lymphatic fluid, and is the most important part of the lymphatic system from a functional point of view. Therefore, understanding the anatomy, physiology, and physiopathology of the lymphatics of the liver is important. However, its anatomy and pathology are relatively unknown because of the absence of commonly used imaging techniques. We describe the anatomy, the physiology, and the pathophysiology of the lymphatic system of the liver and the possibility of identifying dilated lymphatic vessels in various liver diseases and conditions. Disruption of normal lymphatic structure and function is observed in various disease conditions. Liver lymph flow is directly correlated with portal venous pressure. Therefore, a dilatation of liver lymphatics is observed in portal hypertension as well as in increased pressure in hepatic veins. After liver transplantation, ligation of lymphatic vessels at the hilum reduces chylous ascites and results in lymphatic dilatation which is easily observed. In severe long-standing biliary stenosis, dilated lymphatic vessels are commonly demonstrated with non-contrast MR lymphography. In hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and some metastases, lymphatic vessels are abundant in the immediate vicinity of the tumour. These various lymphatic abnormalities can be demonstrated with non-contrast MR lymphography.

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Modern Techniques of Lymphangiography and Interventions: Current Status and Future Development

Cited by 100 publications

References 49 publications

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Chylous Ascites and Lymphoceles: Evaluation and Interventions

Multidisciplinary guidelines for initial evaluation of complicated lymphatic anomalies—expert opinion consensus

Non-contrast MR lymphography of the lymphatic system of the liver

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