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Semin intervent Radiol 2020; 37(03): 250-262
DOI: 10.1055/s-0040-1713442
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Claus Christian Pieper
1   Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Bonn, Bonn, Germany
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Publication Date:
31 July 2020 (online)

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Abstract

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.

Keywords

MR lymphangiography - lymphatic leakage - chylothorax - chylous ascites - lymphatic malformation - interventional radiology
 

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