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Interstitial magnetic resonance lymphography: is it a new method for the diagnosis of lymphedema?
E Dimakakos1, A Koureas, V Koutoulidis
1Vascular Unit, 2nd Department of Surgery, University of Athens, Aretaieion University Hospital, Athens, Greece. edimakakos@yahoo.gr
Aim:
The aim of this study was to evaluate the method of interstitial magnetic resonance lymphography (MRL) as an examination for the depiction of the lymphatic system in humans in comparison with the method of direct X-ray lymphography.
Methods:
We studied 6 persons, 2 volunteers and 4 patients with clinical suspicion of lymphedema in lower extremities. We administered subcutaneous gadobutrol for the MRL with a volume of 5 mL composed of 4.5 mL of Gadobutrol mixed with 0.5 mL of lidocaine hydrochloride and after 7 days lipiodol in the lymph vessel for the X-ray direct lymphography (in 3 patients) in order to compare the findings of the two
Methods:
We then followed up all individuals for 7 days for any possible side effect of the contrast agents.
Results:
Using MRL, we depicted the lymphatic system (lymph vessels and inguinal lymph nodes) of volunteers in 60 min. Moreover, in patients we depicted several abnormalities of the lymphatic system including decreased number of lymph vessels, lymphocele and ectatic lymph vessels. X-ray direct lymphography confirmed the findings of the MRL in all cases. No side effects were observed.
Conclusion:
In our pilot study, Gadobutrol seems to be a good contrast agent for the painless depiction of the lymphatic system in humans through interstitial MRL. More extensive studies are needed in order to establish the efficacy and the dosage of Gadobutrol.
