Anatomic and Functional Evaluation of Central Lymphatics With Noninvasive Magnetic Resonance Lymphangiography
Identifieur interne : 004194 ( Pmc/Curation ); précédent : 004193; suivant : 004195Anatomic and Functional Evaluation of Central Lymphatics With Noninvasive Magnetic Resonance Lymphangiography
Auteurs : Eun Young Kim ; Hye Sun Hwang ; Ho Yun Lee ; Jong Ho Cho ; Hong Kwan Kim ; Kyung Soo Lee ; Young Mog Shim ; Jaeil ZoSource :
- Medicine [ 0025-7974 ] ; 2016.
Abstract
Accurate assessment of the lymphatic system has been limited due to the lack of optimal diagnostic methods. Recently, we adopted noncontrast magnetic resonance (MR) lymphangiography to evaluate the central lymphatic channel. We aimed to investigate the feasibility and the clinical usefulness of noninvasive MR lymphangiography for determining lymphatic disease.
Ten patients (age range 42–72 years) with suspected chylothorax (n = 7) or lymphangioma (n = 3) who underwent MR lymphangiography were included in this prospective study. The thoracic duct was evaluated using coronal and axial images of heavily T2-weighted sequences, and reconstructed maximum intensity projection. Two radiologists documented visualization of the thoracic duct from the level of the diaphragm to the thoracic duct outlet, and also an area of dispersion around the chyloma or direct continuity between the thoracic duct and mediastinal cystic mass.
The entire thoracic duct was successfully delineated in all patients. Lymphangiographic findings played a critical role in identifying leakage sites in cases of postoperative chylothorax, and contributed to differential diagnosis and confirmation of continuity with the thoracic duct in cases of lymphangioma, and also in diagnosing Gorham disease, which is a rare disorder. In patients who underwent surgery, intraoperative findings were matched with lymphangiographic imaging findings.
Nonenhanced MR lymphangiography is a safe and effective method for imaging the central lymphatic system, and can contribute to differential diagnosis and appropriate preoperative evaluation of pathologic lymphatic problems.
Url:
DOI: 10.1097/MD.0000000000003109
PubMed: 27015184
PubMed Central: 4998379
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Anatomic and Functional Evaluation of Central Lymphatics With Noninvasive Magnetic Resonance Lymphangiography</title>
<author><name sortKey="Kim, Eun Young" sort="Kim, Eun Young" uniqKey="Kim E" first="Eun Young" last="Kim">Eun Young Kim</name>
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<author><name sortKey="Hwang, Hye Sun" sort="Hwang, Hye Sun" uniqKey="Hwang H" first="Hye Sun" last="Hwang">Hye Sun Hwang</name>
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<author><name sortKey="Lee, Ho Yun" sort="Lee, Ho Yun" uniqKey="Lee H" first="Ho Yun" last="Lee">Ho Yun Lee</name>
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<author><name sortKey="Cho, Jong Ho" sort="Cho, Jong Ho" uniqKey="Cho J" first="Jong Ho" last="Cho">Jong Ho Cho</name>
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<author><name sortKey="Kim, Hong Kwan" sort="Kim, Hong Kwan" uniqKey="Kim H" first="Hong Kwan" last="Kim">Hong Kwan Kim</name>
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<author><name sortKey="Lee, Kyung Soo" sort="Lee, Kyung Soo" uniqKey="Lee K" first="Kyung Soo" last="Lee">Kyung Soo Lee</name>
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<author><name sortKey="Shim, Young Mog" sort="Shim, Young Mog" uniqKey="Shim Y" first="Young Mog" last="Shim">Young Mog Shim</name>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>Accurate assessment of the lymphatic system has been limited due to the lack of optimal diagnostic methods. Recently, we adopted noncontrast magnetic resonance (MR) lymphangiography to evaluate the central lymphatic channel. We aimed to investigate the feasibility and the clinical usefulness of noninvasive MR lymphangiography for determining lymphatic disease.</p>
<p>Ten patients (age range 42–72 years) with suspected chylothorax (n = 7) or lymphangioma (n = 3) who underwent MR lymphangiography were included in this prospective study. The thoracic duct was evaluated using coronal and axial images of heavily T2-weighted sequences, and reconstructed maximum intensity projection. Two radiologists documented visualization of the thoracic duct from the level of the diaphragm to the thoracic duct outlet, and also an area of dispersion around the chyloma or direct continuity between the thoracic duct and mediastinal cystic mass.</p>
<p>The entire thoracic duct was successfully delineated in all patients. Lymphangiographic findings played a critical role in identifying leakage sites in cases of postoperative chylothorax, and contributed to differential diagnosis and confirmation of continuity with the thoracic duct in cases of lymphangioma, and also in diagnosing Gorham disease, which is a rare disorder. In patients who underwent surgery, intraoperative findings were matched with lymphangiographic imaging findings.</p>
<p>Nonenhanced MR lymphangiography is a safe and effective method for imaging the central lymphatic system, and can contribute to differential diagnosis and appropriate preoperative evaluation of pathologic lymphatic problems.</p>
</div>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Medicine (Baltimore)</journal-id>
<journal-id journal-id-type="iso-abbrev">Medicine (Baltimore)</journal-id>
<journal-id journal-id-type="publisher-id">MEDI</journal-id>
<journal-title-group><journal-title>Medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">0025-7974</issn>
<issn pub-type="epub">1536-5964</issn>
<publisher><publisher-name>Wolters Kluwer Health</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27015184</article-id>
<article-id pub-id-type="pmc">4998379</article-id>
<article-id pub-id-type="doi">10.1097/MD.0000000000003109</article-id>
<article-id pub-id-type="art-access-id">03109</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>6800</subject>
</subj-group>
<subj-group><subject>Research Article</subject>
<subject>Observational Study</subject>
</subj-group>
</article-categories>
<title-group><article-title>Anatomic and Functional Evaluation of Central Lymphatics With Noninvasive Magnetic Resonance Lymphangiography</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Eun Young</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Hwang</surname>
<given-names>Hye Sun</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Ho Yun</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Cho</surname>
<given-names>Jong Ho</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Kim</surname>
<given-names>Hong Kwan</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Lee</surname>
<given-names>Kyung Soo</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Shim</surname>
<given-names>Young Mog</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Zo</surname>
<given-names>Jaeil</given-names>
</name>
<degrees>MD</degrees>
</contrib>
</contrib-group>
<contrib-group><contrib contrib-type="editor"><name><surname>Zhang.</surname>
<given-names>Weisheng</given-names>
</name>
</contrib>
</contrib-group>
<aff>From the Department of Radiology and Center for Imaging Science (EYK, HSH, HYL, KSL); Department of Thoracic and Cardiovascular Surgery (JHC, HKK, YMS, JZ), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and Department of Radiology (EYK), Ajou University School of Medicine, Suwon, Korea.</aff>
<author-notes><corresp>Correspondence: Ho Yun Lee, Department of Radiology and Center for Imaging Science Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea (e-mail: <email>hoyunlee96@gamil.com</email>
).</corresp>
<corresp>Co-correspondence: Jaeil Zo, Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea (e-mail: <email>jayl.zo@samsung.com</email>
).</corresp>
</author-notes>
<pub-date pub-type="collection"><month>3</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>25</day>
<month>3</month>
<year>2016</year>
</pub-date>
<volume>95</volume>
<issue>12</issue>
<elocation-id>e3109</elocation-id>
<history><date date-type="received"><day>22</day>
<month>11</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>17</day>
<month>1</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>13</day>
<month>2</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nd/4.0"><license-p>This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nd/4.0">http://creativecommons.org/licenses/by-nd/4.0</ext-link>
</license-p>
</license>
</permissions>
<self-uri xlink:type="simple" xlink:href="medi-95-e3109.pdf"></self-uri>
<abstract><title>Abstract</title>
<p>Accurate assessment of the lymphatic system has been limited due to the lack of optimal diagnostic methods. Recently, we adopted noncontrast magnetic resonance (MR) lymphangiography to evaluate the central lymphatic channel. We aimed to investigate the feasibility and the clinical usefulness of noninvasive MR lymphangiography for determining lymphatic disease.</p>
<p>Ten patients (age range 42–72 years) with suspected chylothorax (n = 7) or lymphangioma (n = 3) who underwent MR lymphangiography were included in this prospective study. The thoracic duct was evaluated using coronal and axial images of heavily T2-weighted sequences, and reconstructed maximum intensity projection. Two radiologists documented visualization of the thoracic duct from the level of the diaphragm to the thoracic duct outlet, and also an area of dispersion around the chyloma or direct continuity between the thoracic duct and mediastinal cystic mass.</p>
<p>The entire thoracic duct was successfully delineated in all patients. Lymphangiographic findings played a critical role in identifying leakage sites in cases of postoperative chylothorax, and contributed to differential diagnosis and confirmation of continuity with the thoracic duct in cases of lymphangioma, and also in diagnosing Gorham disease, which is a rare disorder. In patients who underwent surgery, intraoperative findings were matched with lymphangiographic imaging findings.</p>
<p>Nonenhanced MR lymphangiography is a safe and effective method for imaging the central lymphatic system, and can contribute to differential diagnosis and appropriate preoperative evaluation of pathologic lymphatic problems.</p>
</abstract>
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