Dynamic contrast-enhanced magnetic resonance lymphangiography in pediatric patients with central lymphatic system disorders

摘要: Central conducting lymphatics (CCLs) disorders represent a broad spectrum of clinical entities ranging from self-limiting traumatic leaks treated by conservative strategies, to complex lymphatic circulation abnormalities that are progressive and unresponsive currently available treatments. Dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) performed intranodal injection gadolinium-based contrast material is recently developed technique which allows minimally invasive evaluation the CCL providing dynamic assessment lymph flow its pathways. In our institution, DCMRL after bilateral cannulation inguinal nodes, using MR protocol includes volumetric 3D T2-SPACE (sampling perfection with application-optimized contrasts different flip-angle evolution) free-breathing respiratory navigated sequence TWIST (time-resolved angiography Interleaved stochastic trajectories) sequence, during paramagnetic medium. Although applications in practice still improving, pathways particularly important both pediatric patients primitive system children congenital heart disease associated impairment.