Contrast-enhanced CT Lymphangiography for Various Central Lymphatic Disorders.

Area of Science:

• Radiology
• Medical Imaging
• Lymphatic System Imaging

Background:

• Lymphatic leakage, including chylothorax and chylous ascites, presents significant health risks like malnutrition and infection.
• Accurate diagnosis and treatment of lymphatic leakage depend on effective lymphatic imaging techniques.
• Conventional lymphangiography and dynamic contrast-enhanced MR lymphangiography (DCMRL) are established methods, but CT lymphangiography (CTL) is emerging.

Purpose of the Study:

• To review the utility of CT lymphangiography (CTL) for diagnosing and managing lymphatic leakage.
• To propose protocols for CTL imaging and interpretation for central lymphatic disorders.
• To highlight the advantages of CTL over conventional imaging methods.

Main Methods:

• Review of existing literature and institutional experience with CT lymphangiography (CTL).
• Description of the contrast-enhanced CTL protocol, including stepwise propagation scanning for radiation dose optimization.
• Outline of interpretation methods for evaluating lymphatic leakage and planning therapeutic interventions.

Main Results:

• CT lymphangiography (CTL) demonstrates superior accessibility and faster imaging acquisition compared to DCMRL.
• The stepwise propagation scanning method in CTL can reduce radiation dose, making it suitable for pediatric patients.
• CTL provides comprehensive imaging for accurate diagnosis and therapeutic planning of lymphatic leakage.

Conclusions:

• CT lymphangiography (CTL) is a prioritized and effective imaging modality for lymphatic leakage, surpassing traditional methods in key aspects.
• The proposed CTL protocol and interpretation guidelines facilitate the evaluation and management of central lymphatic disorders.
• CTL's advantages in accessibility, speed, and radiation dose optimization position it as a valuable tool in lymphatic imaging.