Skip to main content
Log in

Intranodal Lymphangiogram: Technical Aspects and Findings

  • Technical Note
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To report the technical results and imaging findings of intranodal lymphangiogram (INL).

Materials and Methods

we studied four patients (three men, one woman) who had persistent chylous leakage despite conservative treatment after esophageal cancer surgery. Their mean age was 68 years (range 61–74 years). The inguinal or femoral lymph node was punctured under ultrasound guidance using a 60-mm-long, 23-gauge needle. If the lipiodol injected via the needle showed granular nodules on fluoroscopy, lipiodol injection was continued manually at a rate of 1 mL/3 min for INL. If the cisterna chyli was detectable on the lymphangiogram, it was punctured percutaneously via the abdomen by a needle under fluoroscopy, and thoracic duct embolization was performed.

Results

INL was successful in all patients. Lymphaticovenous anastomoses at the femoral or pelvic region were confirmed in all four patients. In one case, a different ipsilateral lymph node was punctured because major flow of lipiodol into the veins through a lymphaticovenous anastomosis occurred. Catheter cannulation and embolization were successful for three of the four patients. In unsuccessful procedures, the cisterna chyli was not visualized, and puncture was not possible.

Conclusions

INL succeeded in all patients. Lipiodol leaked into the vein through a lymphaticovenous anastomosis at the femoral or pelvic region in all patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

References

  1. Cope C, Salem R, Kaiser LR (1999) Management of chylothorax by percutaneous catheterization and embolization of the thoracic duct: prospective trial. J Vasc Interv Radiol 10:1248–1254

    Article  CAS  PubMed  Google Scholar 

  2. Nadolski GJ, Itkin M (2012) Feasibility of ultrasound-guided intranodal lymphangiogram for thoracic duct embolization. J Vasc Interv Radiol 3:613–616

    Article  Google Scholar 

  3. Cope C, Kaiser LR (2002) Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. J Vasc Interv Radiol 13:1139–1148

    Article  PubMed  Google Scholar 

  4. Itkin M, Kucharczuk JC, Kwak A et al (2010) Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg 139:584–589

    Article  PubMed  Google Scholar 

  5. Guermazi A, Brice P, Hennequin C et al (2003) Lymphography: an old technique retains its usefulness. Radiographics 23:1541–1558

    Article  PubMed  Google Scholar 

  6. Hall RC, Krementz ET (1967) Lymphangiography by lymph-node injection. JAMA 202:1136–1139

    Article  CAS  PubMed  Google Scholar 

  7. Koehler PR, Schaffer B (1967) Peripheral lymphatico-venous anastomoses. Report of two cases. Circulation 35:401–404

    Article  CAS  PubMed  Google Scholar 

  8. Takahashi M, Abrams HL (1967) Arborizing pulmonary embolization following lymphangiography. Report of three cases and an experimental study. Radiology 89:633–638

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shuji Kariya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kariya, S., Komemushi, A., Nakatani, M. et al. Intranodal Lymphangiogram: Technical Aspects and Findings. Cardiovasc Intervent Radiol 37, 1606–1610 (2014). https://doi.org/10.1007/s00270-014-0888-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-014-0888-z

Keywords

Navigation