Interventional Management of Acquired Lymphatic Disorders

Kenneth S. Zurcher, Kenneth N. Huynh, Aditya Khurana, Bill S. Majdalany, Beau Toskich, J Scott Kriegshauser, Indravadan J. Patel, Sailendra Naidu, Rahmi Oklu, Sadeer J. Alzubaidi

Research output: Contribution to journalArticlepeer-review

Abstract

The lymphatic system is a complex network of tissues, vessels, and channels found throughout the body that assists in fluid bal-ance and immunologic function. When the lymphatic system is disrupted related to idiopathic, iatrogenic, or traumatic disorders, lymphatic leaks can result in substantial morbidity and/or mortal-ity. The diagnosis and management of these leaks is challenging. Modern advances in lymphatic imaging and interventional techniques have made radiology critical in the multidisciplinary management of these disorders. The authors provide a review of conventional and clinically relevant variant lymphatic anatomy and recent advances in diagnostic techniques such as MR lymphangi-ography. A detailed summary of technical factors related to percutaneous lymphangiography and lymphatic intervention is pre-sented, including transpedal and transnodal lymphangiography. Traditional transabdominal access and retrograde access to the central lymph nodes and thoracic duct embolization techniques are outlined. Newer techniques including transhepatic lymphangi-ography and thoracic duct stent placement are also detailed. For both diagnostic and interventional radiologists, an understanding of lymphatic anatomy and modern diagnostic and interventional techniques is vital to the appropriate treatment of patients with acquired lymphatic disorders.

Original languageEnglish (US)
Pages (from-to)1621-1637
Number of pages17
JournalRadiographics
Volume42
Issue number6
DOIs
StatePublished - Oct 2022

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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