Contrast-enhanced CT Lymphangiography for Various Central Lymphatic Disorders

Lymphatic leakage, manifesting as chylothorax or chylous ascites, arises from traumatic or nontraumatic causes and poses severe risks such as malnutrition and increased infection susceptibility. Accurate diagnosis and an effective treatment strategy necessitate comprehensive lymphatic imaging. Conventional lymphangiography and dynamic contrast-enhanced MR lymphangiography (DCMRL) have been widely used and studied as effective lymphatic imaging methods. Recently, CT lymphangiography (CTL) has been successfully implemented in animal studies and some patients, and the authors' institution now prioritizes CTL over DCMRL. Contrast-enhanced CTL offers a promising alternative, with advantages such as better accessibility and faster imaging. These advantages of CTL over traditional methods highlight its superior accessibility and fast acquisition time. Moreover, to reduce and optimize radiation dose, the stepwise propagation scanning method in CTL could be used, which is especially beneficial in pediatric patients. In this review, the authors suggest the protocol for CTL and interpretation methods for evaluation and therapeutic planning of central lymphatic disorders, focusing on the condition of lymphatic leakage. ^©RSNA, 2024 The slide presentation from the RSNA Annual Meeting is available for this article.