MR lymphangiography: How i do it.
Identifieur interne : 007301 ( Ncbi/Checkpoint ); précédent : 007300; suivant : 007302MR lymphangiography: How i do it.
Auteurs : Lee M. Mitsumori [États-Unis] ; Elizabeth S. Mcdonald [États-Unis] ; Gregory J. Wilson [États-Unis] ; Peter C. Neligan [États-Unis] ; Satoshi Minoshima [États-Unis] ; Jeffrey H. Maki [États-Unis]Source :
- Journal of magnetic resonance imaging : JMRI [ 1522-2586 ] ; 2015.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- methods : Imaging, Three-Dimensional, Lymph Node Excision, Lymphography, Magnetic Resonance Imaging, Surgery, Computer-Assisted.
- pathology : Lymph Nodes, Lymphedema.
- surgery : Lymph Nodes, Lymphedema.
- Humans.
Abstract
Lymphedema is a chronic progressive edematous disease that in the United States is most commonly related to malignancy and its treatment. Lymphaticovenular anastomosis is a recently introduced microsurgical treatment option for lymphedema that requires the identification and mapping of individual lymphatic channels. While nuclear medicine lymphoscintigraphy has been the primary imaging modality performed to evaluate suspected lymphedema, lymphoscintigraphy does not provide the spatial information necessary for presurgical planning. High-resolution dynamic 3D magnetic resonance imaging (MRI) can noninvasively image abnormal lymphatic channels to both diagnose lymphedema and depict the location and number of individual lymphatic channels for surgical planning. MR lymphangiography can be performed at 1.5T or 3.0T using multichannel phased array surface coils. The main components of the exam are a heavily T2 -weighted 3D sequence to define the severity and extent of edema, a high-resolution dynamic 3D gradient echo imaging after intracutaneous contrast injection to visualize lymphatic channels, and a delayed 3D gradient echo sequence after intravenous contrast to define veins. This article reviews the pathophysiology and microsurgical treatment of lymphedema, presents the imaging protocol used at our institution, and describes exam interpretation and the image postprocessing performed for surgical planning.
DOI: 10.1002/jmri.24887
PubMed: 25906741
Affiliations:
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<front><div type="abstract" xml:lang="en">Lymphedema is a chronic progressive edematous disease that in the United States is most commonly related to malignancy and its treatment. Lymphaticovenular anastomosis is a recently introduced microsurgical treatment option for lymphedema that requires the identification and mapping of individual lymphatic channels. While nuclear medicine lymphoscintigraphy has been the primary imaging modality performed to evaluate suspected lymphedema, lymphoscintigraphy does not provide the spatial information necessary for presurgical planning. High-resolution dynamic 3D magnetic resonance imaging (MRI) can noninvasively image abnormal lymphatic channels to both diagnose lymphedema and depict the location and number of individual lymphatic channels for surgical planning. MR lymphangiography can be performed at 1.5T or 3.0T using multichannel phased array surface coils. The main components of the exam are a heavily T2 -weighted 3D sequence to define the severity and extent of edema, a high-resolution dynamic 3D gradient echo imaging after intracutaneous contrast injection to visualize lymphatic channels, and a delayed 3D gradient echo sequence after intravenous contrast to define veins. This article reviews the pathophysiology and microsurgical treatment of lymphedema, presents the imaging protocol used at our institution, and describes exam interpretation and the image postprocessing performed for surgical planning.</div>
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