MR lymphangiography for the assessment of the lymphatic system in patients undergoing microsurgical reconstructions of lymphatic vessels

Lohrmann, Christian; Felmerer, Gunther; Foeldi, Etelka; Bartholomä, Jean-Paul; Langer, Mathias

doi:10.1016/j.mvr.2008.03.003

Cited by 51 publications

(50 citation statements)

References 15 publications

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“…The voxel size obtained in our study was approximately 1/3 of the minimum voxel size achieved at 1.5T (0.512 vs. 1.452 mm 3 ) [8]. Using 15-mm-thick MIPs generated from the high-resolution isotropic 3D data sets considerably facilitated the assessment of the delicate lymph vessels.…”

Section: Discussionmentioning

confidence: 59%

“…However, MRL with perivascular gadolinium injection has been found to be relatively safe in previous studies and experimental animal models, with less tissue damage compared to conventional radiographic contrast media, but is not without at least a temporary adverse effect [6,8,[21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Fat-saturation techniques render image subtraction dispensable and allow for time-efficient acquisition [7]. However, in-plane resolution of MRL is limited at 1.5T (1.1×1.2×1.1 mm 3 ) following constraints associated with the field-strength [8], so that the depiction of typically delicate lymph vessels, with sub-millimeter diameters, may be difficult [6].…”

Section: Introductionmentioning

confidence: 99%

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MR-lymphangiography at 3.0T—a feasibility study

et al. 2009

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The purpose of this study was to establish and evaluate contrast-enhanced MR-lymphangiography (MRL) at 3.0 T for detection and visualization of abnormalities of the peripheral lymphatic system. Sixteen patients were examined with a highly resolved isotropic T1w-3D-GRE-(FLASH) sequence (TR 3.76 ms/TE 1.45 ms/FA 30 degrees /voxel-size 0.8 x 0.8 x 0.8 mm(3)) at 3T after intracutaneous injection of gadolinium-diethylene-triamine-pentaacetic-acid. Two radiologists evaluated overall image quality, contrast between lymph vessels and background tissue, venous contamination, visualized levels, and fat-saturation-homogeneity on 3D maximum-intensity projections. Overall image quality was good to excellent, and all examinations were diagnostic except one, where contrast medium was injected subcutaneously instead of intracutaneously. Overall image quality was good to excellent in 12/16 cases, depiction of lymph vessels was good to excellent in 15/16 cases. Venous contamination was always present, but diagnostically problematical in only one case. Instant lymphatic drainage was observed in unaffected extremities, reaching the pelvic level after approximately 10 min. Lymphatic drainage was considerably delayed in lymphedematous extremities. Ectatic lymph vessels, entrapment, and diffuse drainage of contrast medium correlated with impaired lymphatic drainage. In conclusion, MRL at 3.0 T provides very high spatial resolution and anatomical detail of normal and abnormal peripheral lymph vessels. MRL may thus become a valuable tool for microsurgical treatment planning and monitoring.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MR-lymphangiography at 3.0T—a feasibility study

et al. 2009

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“…Durch bildgebende Verfahren können wichtige Zusatzinformationen für den behandelnden Internisten und Chirurgen gewonnen werden. Dadurch kann eine bessere und individuellere therapeutische Strategie entwickelt werden [ 3 ] . Die Lymphszintigrafi e mit kolloid-gebundenem Technetium 99 m ( 99 m Tc) ist momentan die gebräuchlichste primäre diagnostische Modalität zur Beurteilung von Ursache und Ausdehnung des peripheren Lymphödems.…”

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“…Zudem gelingt die Darstellung der zuführenden Gefäße von Lymphozelen vor deren Exzision, bzw. zur Ableitung der Lymphe vor Lymphozelen oder vor Lymphfi steln [ 3 ] . Da die verwendeten Gadolinium-Chelate wasserlöslich sind und durch Diff usion in die Lymphgefäße gelangen, kann durch Diff usion in die venösen Blutleiter eine venöse Kontamination, d. h. venöse Überlagerungseff ekte entstehen, die zu einer eingeschränkten Beurteilung der Lymphgefäße führen können [ 8 ] .…”

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