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https://www.readbyqxmd.com/read/28214496/new-diagnostic-modalities-in-the-evaluation-of-lymphedema
#1
REVIEW
Thomas F O'Donnell, John C Rasmussen, Eva M Sevick-Muraca
OBJECTIVE: Currently, lymphedema (LED) is typically diagnosed clinically on the basis of a patient's history and characteristic physical findings. Whereas the diagnosis of LED is sometimes confirmed by lymphoscintigraphy (LSG), the technique is limited in both its ability to identify disease and to guide therapy. Recent advancements provide opportunities for new imaging techniques not only to assist in the diagnosis of LED, based on anatomic changes, but also to assess contractile function and to guide therapeutic intervention...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28169139/comparative-analysis-of-intranodal-lymphangiography-with-percutaneous-intervention-for-postsurgical-chylous-effusions
#2
Michael Yannes, Donghoon Shin, Kevin McCluskey, Rakesh Varma, Ernesto Santos
PURPOSE: To evaluate clinical success and time to resolution of intranodal lymphangiography (INL) alone or with thoracic duct embolization (TDE) or thoracic duct disruption (TDD) based on initial effusion volume for postsurgical chylothorax. MATERIALS AND METHODS: Retrospective review was performed of 57 patients (mean age 63 y; 65% male) undergoing INL alone or in conjunction with other percutaneous techniques for postsurgical chylous effusions. INL alone was performed when chylothorax output was ≤ 500 mL/d and no leak was identified during fluoroscopy...
February 3, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28149811/usefulness-of-cbct-and-guidance-software-for-percutaneous-embolization-of-a-lymphatic-leakage-after-thyroidectomy-for-cancer
#3
Anna Maria Ierardi, Vincenzo Pappalardo, Xiaoli Liu, Che-Wei Wu, Angkoon Anuwong, Hoon Yub Kim, Renbin Liu, Matteo Lavazza, Davide Inversini, Andrea Coppola, Chiara Floridi, Luigi Boni, Gianpaolo Carrafiello, Gianlorenzo Dionigi
Lymphatic leakage can develop as an iatrogenic complication of thoracic, cardiac, and neck surgery. The management of this complication may be challenging and involves more specialists. Percutaneous, image-guided techniques may offer two advantages: mini-invasivity and ability to image and identify the anatomy and the site of the leakage. We report a case of refractory cervical chylous leakage after thyroidectomy and lymphadenectomy for cancer that was successfully treated with an ultrasound-guided intranodal lymphangiography and a percutaneous puncture of the leak performed using CBCT as imaging guidance...
December 2016: Gland Surgery
https://www.readbyqxmd.com/read/28132530/computed-tomography-lymphangiography-findings-in-27-cases-of-lymphangioleiomyomatosis
#4
Chunyan Zhang, Xiaobai Chen, Tingguo Wen, Qijin Zhang, Meng Huo, Jian Dong, Wen-Bin Shen, Rengui Wang
Background Lymphangioleiomyomatosis (LAM) is a rare disease involving the bronchi, lymphatic vessels, and veins. However, there are few reports about lymphatic vessel abnormalities associated with LAM. Purpose To evaluate computed tomography (CT) lymphangiography findings in cases of LAM, especially lymphatic vessel abnormalities. Material and Methods Twenty-seven patients with LAM underwent direct lymphangiography (DLG), followed by a post-procedural thoracoabdominal CT examination. Results All 27 patients were diagnosed with LAM, including 25 (93%) with chylothorax, eight (30%) with chyloperitoneum, seven (26%) with chylous fluid in the chest and abdomen, and one (4%) with lower-limb lymphedema...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28018713/in-vivo-label-free-lymphangiography-of-cutaneous-lymphatic-vessels-in-human-burn-scars-using-optical-coherence-tomography
#5
Peijun Gong, Shaghayegh Es'haghian, Karl-Anton Harms, Alexandra Murray, Suzanne Rea, Fiona M Wood, David D Sampson, Robert A McLaughlin
We present an automated, label-free method for lymphangiography of cutaneous lymphatic vessels in humans in vivo using optical coherence tomography (OCT). This method corrects for the variation in OCT signal due to the confocal function and sensitivity fall-off of a spectral-domain OCT system and utilizes a single-scattering model to compensate for A-scan signal attenuation to enable reliable thresholding of lymphatic vessels. A segment-joining algorithm is then incorporated into the method to mitigate partial-volume effects with small vessels...
December 1, 2016: Biomedical Optics Express
https://www.readbyqxmd.com/read/27993326/interventional-treatment-of-pulmonary-lymphatic-anomalies
#6
REVIEW
Maxim Itkin
Pulmonary lymphatic diseases have been recognized for many years and have been referred as pulmonary lymphangiectasia, pulmonary lymphangiomatosis, plastic bronchitis, and idiopathic chylothorax or chylopericardium. The lymphatic etiology of these conditions has been determined by detection of cystic lymphatic structures on biopsy or postmortem examination. Development of new imaging techniques such as dynamic contrast-enhanced magnetic resonance lymphangiography has allowed better understanding of pathophysiology of these conditions...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993325/percutaneous-treatment-of-chylous-ascites
#7
REVIEW
Jinoo Kim, Je Hwan Won
Chylous ascites occurs as a result of lymphatic leakage, which contains high concentration of triglycerides. The leakage is caused by various benign or malignant etiologies ranging from congenital lymphatic abnormality to trauma. Lymphangiography has been shown to be effective in the diagnosis of lymphatic leakage and has also been reported to have therapeutic outcome. The development of intranodal technique for lymphangiography has recently made the procedure more widespread. As an adjunctive procedure, percutaneous embolization may be performed which involves use of embolic agents such as N-butyl cyanoacrylate and coil to occlude the leak...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993324/nontraumatic-chylothorax-diagnostic-algorithm-and-treatment-options
#8
REVIEW
Gregory Nadolski
Nontraumatic chylothorax is a relatively rare condition in which the intestinal lymph (chyle) leaks into the pleural cavity. Nontraumatic chylothorax is more difficult to treat than the more common traumatic chylothorax because the site of chylous leak may occur in less predictable locations. In the past, patients with nontraumatic chylothoraces were offered traditional fluoroscopically guided lymphangiography and thoracic duct embolization similar to traumatic chylothorax. However, the observation that thoracic duct embolization outcomes for nontraumatic chylothorax differed based on the imaging findings during lymphangiography has led to the development of a treatment algorithm, which incorporates noninvasive diagnostic studies, such as magnetic resonance lymphangiography...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993323/lymphangiography-for-thoracic-duct-interventions
#9
REVIEW
Michael S Stecker, Chieh-Min Fan
Lymph leaks resulting in chylous pleural effusions can be life-threatening. Minimally invasive thoracic duct embolization and disruption have been gaining acceptance as first-line treatment for these leaks. This review discusses the techniques for both pedal and intranodal lymphangiography in detail. It also discusses the use of lymphangiography as a means of targeting a retroperitoneal lymphatic to facilitate thoracic duct interventions for chyle leaks. Finally, outcomes and adverse events pertaining to these thoracic duct interventions are discussed...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993321/peripheral-magnetic-resonance-lymphangiography-techniques-and-applications
#10
REVIEW
Lee M Mitsumori, Elizabeth S McDonald, Peter C Neligan, Jeffrey H Maki
Peripheral lymphedema is a chronic progressive and debilitating disorder that results from abnormal lymphatic drainage. Advances in microsurgical techniques have led to the development of new treatment options for lymphedema that benefit from preoperative imaging to select the most appropriate surgical repair. Magnetic resonance (MR) lymphangiography is a noninvasive imaging modality capable of providing high-resolution 3D images of the lower extremities to define the severity and extent of lymphedema and depict individual lymphatic channels...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993320/novel-lymphatic-imaging-techniques
#11
REVIEW
Yoav Dori
The lymphatic system plays an important role in immune regulation, transport of metabolites, and fluid balance. The key circulatory role of the lymphatic system is to transport fluid from tissue back into the venous system via lymphovenous connections. Despite the centuries-old recognition of this key role, there has been poor understanding of lymphatic flow pathophysiology because of a lack of a simple reliable noninvasive clinical lymphatic imaging method. This lack of clinical imaging has limited the treatment options for patients with lymphatic flow disorders...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993319/lymphatic-anatomy
#12
REVIEW
Michael C Hsu, Maxim Itkin
Recent development of new lymphatic imaging and intervention techniques, such as intranodal lymphangiogram, dynamic contrast enhanced magnetic resonance lymphangiography and lymphatic embolization, have resulted in the resurgence of interest in the lymphatic anatomy. The lymphatic system is a continuous maze of interlacing vessels and lymph nodes and is extremely complex and variable. This presents a significant challenge for interpretation of imaging and performance of interventions on this system. There is an embryological reason for this complexity and variability; the lymphatic system sprouts off of primordia from several locations in the body, which later fuse together at different stages of development of the embryo...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27942023/lymph-node-transplantation-decreases-swelling-and-restores-immune-responses-in-a-transgenic-model-of-lymphedema
#13
Jung-Ju Huang, Jason C Gardenier, Geoffrey E Hespe, Gabriela D García Nores, Raghu P Kataru, Catherine L Ly, Inés Martínez-Corral, Sagrario Ortega, Babak J Mehrara
INTRODUCTION: Secondary lymphedema is a common complication of cancer treatment and recent studies have demonstrated that lymph node transplantation (LNT) can decrease swelling, as well as the incidence of infections. However, although these results are exciting, the mechanisms by which LNT improves these pathologic findings of lymphedema remain unknown. Using a transgenic mouse model of lymphedema, this study sought to analyze the effect of LNT on lymphatic regeneration and T cell-mediated immune responses...
2016: PloS One
https://www.readbyqxmd.com/read/27866702/elucidation-of-percutaneously-accessible-lymph-nodes-in-swine-a-large-animal-model-for-interventional-lymphatic-research
#14
Dara Kraitchman, Ihab Kamel, Clifford Weiss, Christos Georgiades
PURPOSE: To define percutaneously accessible, anatomically reproducible swine lymph nodes using magnetic resonance imaging, ultrasound, and ethiodized oil (Lipiodol; Guerbet, Bloomington, Indiana) lymphangiography. MATERIALS AND METHODS: Five adult female swine (Yorkshire, 50-60 kg) were used. Under general anesthesia, T1-weighted and T2-weighted, coronal and axial images of the entire swine were obtained. The animal's extrathoracic, extraperitoneal soft tissues from the neck to the groins were examined with ultrasound...
November 17, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27845836/diffuse-pulmonary-lymphangiomatosis-mdct-findings-after-direct-lymphangiography
#15
Xiaoli Sun, Wenbin Shen, Song Xia, Tingguo Wen, Rengui Wang
OBJECTIVE: The aim of this study was to analyze the findings of MDCT performed after direct lymphangiography in patients with diffuse pulmonary lymphangiomatosis. MATERIALS AND METHODS: Twenty-three patients (13 male and 10 female patients) diagnosed with diffuse pulmonary lymphangiomatosis on the basis of clinical features and findings from imaging, bronchoscopy, and pathologic analysis were retrospectively evaluated. All patients underwent pulmonary MDCT after direct lymphangiography, surgical operation or open lung biopsy, and histopathologic examination...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27831840/lymphatic-intervention-for-various-types-of-lymphorrhea-access-and-treatment
#16
Masanori Inoue, Seishi Nakatsuka, Hideki Yashiro, Masashi Tamura, Yohsuke Suyama, Jitsuro Tsukada, Nobutake Ito, Sota Oguro, Masahiro Jinzaki
Traumatic lymphorrhea is a rare but potentially life-threatening complication. Postoperative lymphorrhea is the leading cause of traumatic lymphorrhea and can arise anywhere within the lymphatic system. Leaks arising from the aortoiliac region to the thoracic duct (TD) and from hepatic lymphatics can be identified with intranodal lymphangiography and transhepatic lymphangiography, respectively. Therefore, an appropriate lymphangiography technique is essential for identifying the sources of leaks. Chylothorax resulting from damage to the TD can be serious because the TD transports large amounts of lymphatic fluid from the gastrointestinal, hepatic, and aortoiliac regions...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27807557/ultrasound-guided-intranodal-lymphangiography-with-ethiodized-oil-to-treat-chylous-ascites
#17
Sho Kitagawa, Wataru Sakai, Takashi Hasegawa
A 70-year-old man presented with abdominal distention and pain. A diagnosis of chylous ascites (CA) was made by abdominal paracentesis. Conservative treatment had failed to control CA; therefore, ultrasound-guided intranodal lymphangiography (UIL) with Lipiodol was performed. No obvious Lipiodol leakage was observed in the follow-up computed tomography; however, the persistent abdominal pain was significantly reduced within a day, and CA was resolved within 3 days. We present successful treatment of CA using UIL with Lipiodol...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27778074/chylous-ascites-management-after-pancreatic-surgery
#18
Nicolas Tabchouri, Eric Frampas, Frederic Marques, Claire Blanchard, Adam Jirka, Nicolas Regenet
BACKGROUND: Postoperative chylous ascites (CA) following pancreatic surgery is uncommon. If left untreated, it leads to malnutrition, immunodeficiency and increased postoperative morbidity and mortality. The aim of this study was to seek out risk factors associated with CA onset and conservative treatment (CT) failure in order to determine better management of CA following pancreatic resection. MATERIALS AND METHODS: All consecutive patients who underwent pancreatic surgery between 2004 and 2014 were reviewed retrospectively...
October 24, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27743087/embolization-for-thoracic-duct-collateral-leakage-in-high-output-chylothorax-after-thoracic-surgery
#19
Shuji Kariya, Miyuki Nakatani, Rie Yoshida, Yutaka Ueno, Atsushi Komemushi, Noboru Tanigawa
PURPOSE: This study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route. METHODS: Data were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery...
January 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27671000/hur-s-shin-jh-lee-ij-et-al-early-experience-in-the-management-of-postoperative-lymphatic-leakage-using-lipiodol-lymphangiography-and-adjunctive-glue-embolization-j-vasc-interv-radiol-2016-27-1177-1186
#20
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Journal of Vascular and Interventional Radiology: JVIR
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