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Published on: May 1, 2015
Lymphatic anomalies in congenital heart disease
Karen I Ramirez-Suarez1, Luis Octavio Tierradentro-García1, David M Biko1,2
1Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
Insights
Congenital heart disease can cause lymphatic issues. Dynamic contrast-enhanced magnetic resonance (MR) lymphangiography aids in diagnosing and managing these lymphatic complications in children.
Area of Science:
- Pediatric Cardiology
- Radiology
- Lymphatic Imaging
Background:
- Congenital heart disease (CHD) is associated with diverse lymphatic complications.
- These complications include lymphatic leaks, overproduction, conduction issues, and lymphedema.
- Recent advancements in lymphatic imaging and interventions have improved pediatric outcomes.
Purpose of the Study:
- To review lymphatic abnormalities in children with CHD as visualized by MRI.
- To discuss the utility of dynamic contrast-enhanced MR lymphangiography for lymphatic disorders.
- To provide a brief overview of current treatment strategies for these conditions.
Main Methods:
- Review of current literature on lymphatic abnormalities in pediatric CHD.
- Focus on dynamic contrast-enhanced MR lymphangiography for assessing lymphatic drainage.
- Discussion of MRI findings in conditions like plastic bronchitis, chylothorax, and chylous ascites.
Main Results:
- MRI, particularly dynamic contrast-enhanced MR lymphangiography, is effective for evaluating lymphatic drainage abnormalities.
- This imaging modality is crucial for diagnosing various lymphatic disorders secondary to CHD.
- Improved understanding of lymphatic complications aids in better patient management.
Conclusions:
- MRI is a key tool for identifying and characterizing lymphatic complications in children with CHD.
- Dynamic contrast-enhanced MR lymphangiography offers detailed assessment of lymphatic system dysfunction.
- Comprehensive management involves accurate diagnosis through advanced imaging and timely intervention.
Abstract:
Congenital heart disease can lead to various lymphatic complications including traumatic leaks, lymphatic overproduction, conduction abnormalities or lymphedema. Advancements in the imaging of central lymphatics and guided interventions have improved outcomes in these children. Dynamic contrast-enhanced magnetic resonance (MR) lymphangiography allows for the assessment of abnormal lymphatic drainage. This technique is preferred for evaluating lymphatic conditions such as plastic bronchitis, chylothorax, chyloptysis, chylopericardium, protein-losing enteropathy and chylous ascites, among other lymphatic disorders. In this review, we discuss lymphatic abnormalities encountered on MRI in children with congenital heart disease. We also briefly review treatment options.
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