Intranodal cone-beam computed tomographic lymphangiography with water-soluble iodinated contrast agent for evaluating
Dicken Wong1, Kin Fen Kevin Fung2, Hay-Son Robin Chen3
1Department of Diagnostic and Interventional Radiology, Kwong Wah Hospital, Hong Kong, Hong Kong.
Insights
Cone-beam CT lymphangiography (CBCTL) is useful for diagnosing lymphatic disorders in infants. This technique helped identify central lymphatic flow disorder in two infants with complex heart conditions.
Area of Science:
- Medical Imaging
- Pediatric Cardiology
- Lymphatic System Imaging
Background:
- Infants with dextro-transposition of the great arteries (d-TGA) can develop high-output chylothoraces.
- Chylothoraces in infants often require advanced diagnostic imaging.
- MRI and oil-based contrast agents are contraindicated in certain pediatric cases.
Purpose of the Study:
- To evaluate the diagnostic utility of cone-beam CT lymphangiography (CBCTL) in infants with lymphatic disorders.
- To assess CBCTL as an alternative imaging modality when MRI and oil-based contrast agents are not feasible.
Main Methods:
- Cone-beam CT lymphangiography (CBCTL) was performed using intranodal injection of a water-soluble iodinated contrast agent.
- The study involved two infants with d-TGA and chylothoraces.
- Diagnostic findings were correlated with clinical presentation and management.
Main Results:
- CBCTL successfully visualized lymphatic anatomy and flow in both infants.
- Central lymphatic flow disorder was diagnosed in both cases based on CBCTL findings.
- The technique provided crucial diagnostic information for guiding management.
Conclusions:
- Cone-beam CT lymphangiography (CBCTL) with water-soluble contrast is a valuable diagnostic tool for pediatric lymphatic disorders.
- CBCTL offers a viable alternative for lymphatic imaging in infants with contraindications to MRI or oil-based contrast agents.
- This imaging modality aids in the diagnosis of central lymphatic flow disorders in complex pediatric cases.
Abstract:
This brief report demonstrates the diagnostic utility of cone-beam CT lymphangiography (CBCTL) with intranodal injection of water-soluble iodinated contrast agent for assessing lymphatic disorders in two infants who were contraindicated for MRI and oil-based contrast agent. Both infants had dextro-transposition of the great arteries (d-TGA) and presented with high-output chylothoraces that were recalcitrant to conservative medical therapy. Both infants were diagnosed with central lymphatic flow disorder based on the CBCTL findings.
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