MR Lymphangiography



The imaging of lymphatic system is much difficult than that of blood circulation due to several reasons. Firstly, lymphatic vessels are slender, fragile, and transparent. Thus, to approach lymphatic vessel and deliver contrast directly is not easy. Secondly, the diameters of lymphatic vessel are small and the wall has less smooth muscle cell that leads to a weak contraction at a low rhythm. Lymph flow at a lower speed is a nonconstant stream under normal condition. Therefore, lymphatic pathway may not always be visualized during imaging. Thirdly, the composition of lymphatic system network is more complex than the blood system. There are around 600 of lymph nodes in human body, which distribute between every two or more efferent and afferent lymphatic vessels [1]. The commonly used lymphoscintigraphy with isotopic contrast agent has insufficient resolution to accurately outline the internal anatomy of lymph node and lymphatic vessels. Lymphangiography using iodine oil agent, which is capable of visualizing the lymphatics, is no longer routinely performed because it is highly invasive and difficult to perform and also can lead to life-threatening complications. As a new diagnostic test, 3D high-resolution MR lymphangiography (MRL) has been proven to be useful in the diagnosis of peripheral lymphatic system disorders in recent years [2–5]. Around 2000 patients have been examined in the author’s clinic since 2007. MR lymphangiography with gadobenate dimeglumine quickly and sufficiently visualizes the lymphatic pathway and lymph nodes draining from the intracutaneously injection sites in lymphedematous limbs and gives both morphological and functional assessments of tested lymphatic system.


  1. 1.
    Kubik S. Anatomy of the lymphatic system. In: Foldi M, Foldi E, Kubik S, editors. Textbook of lymphology. München: Elsevier GmbH; 2003. p. 34–5.Google Scholar
  2. 2.
    Liu NF, Lu Q, Jiang ZH. Anatomic and functional evaluation of lymphatics and lymph nodes in diagnosis of lymphatic circulation disorders with contrast magnetic resonance lymphangiography. J Vasc Surg. 2009;49:980–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Liu NF, Lu Q, Wu XF. Comparison of radionuclide lymphoscintigraphy and dynamic magnetic resonance lymphangiography for investigating extremity lymphoedema. Br J Surg. 2010;97:359–65.CrossRefPubMedGoogle Scholar
  4. 4.
    Lohrmann C, Foeldi E, Bartholome JP. Godoteridol for MR imaging of lymphatic vessels in lymphoedematous patients:initial experience after intracutaneous injection. Br J Radiol. 2007;80:569–73.CrossRefPubMedGoogle Scholar
  5. 5.
    Lu Q, Xu J, Liu N. Chronic lower extremity lymphedema: a comparative study of high- resolution interstitial MR lymphangiography and heavily T2-weighted MRI. Eur J Radiol. 2010;73:365–73.CrossRefPubMedGoogle Scholar
  6. 6.
    Ruehm SG, Corot C, Debatin JF. Interstitial MR lymphgraphy with a conventional extracellular gadolinium-based agent: assessment in rabbits. Radiology. 2001;218:664–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Liu NF, Yan ZX. Classification of lymphatic system malformations in primary lymphoedema based on MR lymphangiography. Eur J Vascu Endovasc Surg. 2012;44:345–9.CrossRefGoogle Scholar
  8. 8.
    Liu NF, Wang BS. Functional lymphatic collectors in breast cancer-related lymphedema arm. Lymphat Res Biol. 2014;12:232–7.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Liu NF, Yan ZX, Wu XF, Luo Y. Spontaneous lymphatic disruption and regeneration in obstructive lymphoedema. Lymphology. 2013;46:56–63.PubMedGoogle Scholar
  10. 10.
    Liu NF, Yan ZX, Lu Q, Wang CG. Diagnosis of Inguinal lymph node metastases using contrast enhanced high resolution MR lymphangiography. Acad Radiol. 2013;20:218–23.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Lymphology Center of Department of Plastic and Reconstructive SurgeryShanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina

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