Direct contrast-enhanced magnetic resonance

J Vasc Surg Venous Lymphat Disord · Mar 2019

Case Reports

Direct contrast-enhanced magnetic resonance lymphangiography in the diagnosis of persistent occult chylous effusion leak after thoracic duct embolization.

Thoracic duct embolization (TDE) is currently the technique of choice for chylothorax refractory to medical management. Diagnosis and treatment of persistent lymphatic leakage after an initially successful TDE are complicated by inadequate imaging to localize the nidus of the lymphatic leak. Traditional imaging modalities including nuclear medicine lymphoscintigraphy, magnetic resonance lymphangiography, and fluoroscopic lymphangiography lack spatial resolution and dynamic physiologic real-time evaluation. We report a contemporary imaging technique using direct contrast-enhanced magnetic resonance lymphangiography to diagnose an occult chylous leak after TDE.

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- Sharon C Kiang, Khwaja A Ahmed, Samual Barnes, Ahmed M Abou-Zamzam, and Roger T Tomihama.
- Division of Vascular Surgery, Department of Surgery, Loma Linda University School of Medicine, Loma Linda, Calif; Division of Vascular Surgery, Department of Surgery, VA Loma Linda Healthcare System, Loma Linda, Calif.
- J Vasc Surg Venous Lymphat Disord. 2019 Mar 1; 7 (2): 251-257.
AbstractThoracic duct embolization (TDE) is currently the technique of choice for chylothorax refractory to medical management. Diagnosis and treatment of persistent lymphatic leakage after an initially successful TDE are complicated by inadequate imaging to localize the nidus of the lymphatic leak. Traditional imaging modalities including nuclear medicine lymphoscintigraphy, magnetic resonance lymphangiography, and fluoroscopic lymphangiography lack spatial resolution and dynamic physiologic real-time evaluation. We report a contemporary imaging technique using direct contrast-enhanced magnetic resonance lymphangiography to diagnose an occult chylous leak after TDE.Copyright © 2018 Society for Vascular Surgery. All rights reserved.

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Direct contrast-enhanced magnetic resonance lymphangiography in the diagnosis of persistent occult chylous effusion leak after thoracic duct embolization.

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