Lymphography of the Thoracic Duct by Percutaneous Injection of Iohexol into the Popliteal Lymph Node of Dogs: Experimental Study and Clinical Application

Naganobu, Kiyokazu; Ohigashi, Yusuke; Akiyoshi, Tomomi; Hagio, Mitsuyoshi; Miyamoto, Toru; Yamaguchi, Ryoji

doi:10.1111/j.1532-950x.2006.00160.x

Cited by 49 publications

(50 citation statements)

References 8 publications

(10 reference statements)

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“…A previous study reported that radiography with an inadequate delay time requires additional injection of iohexol into the popliteal lymph node [8]. The present study also suggests that determination of the delay time for computed tomographic scanning is necessary due to the disappearing nature of the contrast media in the thoracic duct.…”

Section: Discussionmentioning

confidence: 49%

“…Naganobu et al described performance of popliteal lymphography by injection of iohexol with a volume of 5 to 10 ml and an injection time of an average of 5 min. Although we used similar methods, smaller amounts of iohexol (60 mgI/kg) were used, which facilitates a much faster injection time without a loss of image quality in lymphatic duct opacification [8].…”

Section: Discussionmentioning

confidence: 99%

“…A study in 2006 demonstrated that percutaneous injection of contrast medium into popliteal lymph nodes can visualize the thoracic duct well [8]. However, further study was necessary in regard to the optimal dose of contrast media and delay time for radiographic and computed tomographic lymphography because the popliteal lymph node has a limited capacity for injection, and too large a dose of contrast media can result in long a injection time.…”

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confidence: 99%

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Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Chun

Cho

Cheon

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. The purposes of this study were to determine the optimal dose and delay time for lymphography by injection of Iohexol into popliteal lymph nodes and to assess images of computed tomography by the established protocol. Three different doses (30, 60 and 90 mgI/kg) of water-soluble iodinated contrast medium were injected into 15 popliteal lymph nodes of 10 adult beagles, and fluoroscopy was performed. Filling and duration of contrast media and the number of visible ducts from popliteal lymph nodes to the thoracic duct and its branches were recorded. CT lymphography was performed, and the number of visible thoracic ducts was compared with that found by radiographic lymphography. Radiographs obtained between 130 and 800 seconds after injection of contrast medium provided a detailed view of the thoracic duct. The dose of 60 mgI/kg was determined to enable quality diagnostic imaging without extranodal leakage in radiographic lymphography. There was no significant difference in the number of thoracic ducts between the two modalities at each anatomic location. However, CT lymphography provided images of the thoracic duct with better spatial resolution and without superimposition of surrounding tissue. The present study provides an adequate delay time and injection for identification of the canine thoracic duct, and therefore, this technique could be applied to diagnosis of disease associated with chest lymphatic drainage.KEY WORDS: CT, dog, Percutaneous ultrasound guided popliteal lymphograhy, thoracic duct.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Chun

Cho

Cheon

et al. 2009

The Journal of Veterinary Medical Science

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“…In comparison, results of previous studies have been variable. For instance, Naganobu et al (2006) observed a 100% contrast uptake into the TD after an injection of 10 ml of iohexol at 300 mg/ml into the popliteal LN of healthy experimental dogs. These results suggest that the success rate of popliteal lymphangiography in dogs is higher than in pigs.…”

Section: Discussionmentioning

confidence: 99%

Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Vnuk¹,

Kurilj²,

Matičić³

et al. 2014

Vet. Med. - Czech

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Radiographic contrast studies have been recommended to identify the thoracic duct (TD) and its branches before and after surgery for total occlusion. The macroscopic identification of the TD and its branches during surgery usually involves injection of methylene blue (MB). Radiographic contrast and methylene blue can be injected into different anatomical structures (lymph node, lymph vessel, s.c.). The purpose of this study was to compare two different techniques (radiographic and thoracoscopic) for visualisation of the TD after intrapopliteal lymph node injection in the pig. Six piglets from the same litter (two males and four females), two months of age were used. Iohexol at 245 mg/ml was injected into the left popliteal lymph node (LN) under general anaesthesia; hindlimb, abdominal, and thoracic radiographs were taken. A 0.25% methylene blue solution was injected into the right popliteal lymph node and the thoracic duct colouration was assessed thoracoscopically. The thoracic duct was visualised radiographically in one out of six pigs after iohexol injection and thoracoscopically in five out of six pigs after methylene blue injection. The difference was statistically significant (P = 0.040). Popliteal LN lymphangiography using iohexol at 245 mg/ml in piglets should not be the recommended method for TD visualisation. Intrapopliteal injection of a 0.25% solution of methylene blue is recommended as a method of TD visualisation prior to thoracic duct ligation.

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“…To visualize the thoracic duct, dyes such as India ink (for anatomical purpose) and methylene blue (MB) or X-ray contrast media have been injected into the mesenteric, inguinal, popliteal, and metatarsal lymph vessels [1,3,8] or the mesenteric, popliteal, and axillary lymph nodes [5,9,12]. However, except for the popliteal lymph node, surgery is required to approach these nodes and vessels, before injections of dyes or X-ray contrast media.…”

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confidence: 99%

Visualization of the Thoracic Duct with Injections of Dyes or Contrast Media into the Testicular Parenchyma in the Rabbit

Tsuruno

Shibazaki

Kanda

et al. 2009

The Journal of Veterinary Medical Science

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ABSTRACT. The thoracic duct drains lymph from the caudal part of the body to the venous system. The visualization of the thoracic duct is important for diagnosis of chylothorax, which may be caused by the damage of the duct. However, it is not easy to visualize the thoracic duct by injecting dyes and/or contrast media into peripheral lymph nodes and mesenteric lymphatics. In the present study, we examined whether the thoracic duct can be visualized by injecting dyes and contrast media directly into the testicular parenchyma. Under deep pentobarbital anesthesia, 14 male Japanese White rabbits were percutaneously injected with dyes (India ink or methylene blue) or contrast media (iohexol 240, 300, or Lipiodol TM ) into the testicular parenchyma. Then, we grossly observed the stained thoracic duct or took radiographs and CT images of the duct. In all cases with dyes injections, the thoracic duct was successfully visualized. We observed stained lymphatic vessels from the testis to the duct. In case of contrast media injections, the thoracic duct was visualized with X-ray and CT imaging, when 1.5-2.0 ml per one testis of iohexol 240 at 37C were injected into the right or both testes. The duct was most clearly visible, 3-5 min after the injections. The results show that the thoracic duct is reliably visualized simply by injecting dyes or contrast media into the testicular parenchyma. Our visualization method may also be applicable to the diagnosis of chylothorax in male animals. The thoracic duct is the main lymphatic channel that drains lymph from the caudal part of the body to the venous system. The damage of the thoracic duct causes chylothorax that is characterized by accumulation of chyle in the pleural cavity. In such cases, the visualization of the thoracic duct is important for diagnosis and treatment of chylothorax in veterinary practice [3,4].To visualize the thoracic duct, dyes such as India ink (for anatomical purpose) and methylene blue (MB) or X-ray contrast media have been injected into the mesenteric, inguinal, popliteal, and metatarsal lymph vessels [1,3,8] or the mesenteric, popliteal, and axillary lymph nodes [5,9,12]. However, except for the popliteal lymph node, surgery is required to approach these nodes and vessels, before injections of dyes or X-ray contrast media. Furthermore, technical skills are also needed, when injections are made into these thin lymphatics especially in small dogs and cats. An alternative, less invasive method is injections of dyes or contrast media into the popliteal lymph nodes. However, it has been reported that popliteal injections visualize the thoracic duct less reliably than mesenteric injections [5].Recent studies have shown that the testicular efferent and abdominal lymphatics were visualized by injections of dyes such as patent blue violet and India ink or X-ray contrast media such as ethyl ester of iodinated poppy-seed oil fatty acid into the testicular parenchyma in the rat [2,10]. The results of these studies suggest the possibility that the thoracic duct co...

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Lymphography of the Thoracic Duct by Percutaneous Injection of Iohexol into the Popliteal Lymph Node of Dogs: Experimental Study and Clinical Application

Abstract: Percutaneous popliteal lymph node administration of iohexol should be considered as an alternative to mesenteric lymph node injection for radiographic identification of the thoracic duct in dogs.

Cited by 49 publications

References 8 publications

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Determination of Optimal Dosage and Delay Time for Computed Tomographic Lymphography after Percutaneous Injection of Iohexol into Popliteal Lymph Nodes in Dogs

Visualisation of the thoracic duct after popliteal lymph node injection in the pig: comparison of radiographic and thoracoscopic techniques

Visualization of the Thoracic Duct with Injections of Dyes or Contrast Media into the Testicular Parenchyma in the Rabbit

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