Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema

R. D. White, J. R. Weir-McCall, M. J. Budak, S. A. Waugh, D. A. Munnoch, T. A. P. Sudarshan (Lead / Corresponding author)

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Chronic lower limb lymphoedema is a debilitating condition that may occur as a primary disorder or secondary to other conditions. Satisfactory visualization of the lymphatic vessels to aid diagnosis and surgical planning has been problematic. Historically, direct lymphography was used to visualize lymphatic vessels, although the significant surgical risks involved led to this being largely abandoned as a technique. Technetium-99m lymphoscintigraphy has been the mainstay of diagnosis for over two decades, but is hampered by inherently poor temporal and spatial resolution and limited anatomical detail. Contrast-enhanced magnetic resonance lymphography (MRL) is a relatively new technique that shows early promise in the evaluation of chronic lymphoedema. This article provides the procedural technique for lower limb MRL at both 1.5 and 3 T, discusses pathophysiology and classifications of lymphoedema, provides an overview of relevant lower limb lymphatic anatomy using MRL imaging, compares the various techniques used in the diagnosis of lower limb lymphoedema, shows common pathological MRL imaging findings, and describes alternative uses of MRL. Utilization of this technique will allow more accurate diagnosis and classification of patients suffering from lymphoedema.
Original languageEnglish
Pages (from-to)e435-e444
Number of pages10
JournalClinical Radiology
Volume69
Issue number11
Early online date23 Jul 2014
DOIs
Publication statusPublished - Nov 2014

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Lymphography
Lymphedema
Lower Extremity
Magnetic Resonance Spectroscopy
Lymphatic Vessels
Magnetic Resonance Imaging
Lymphoscintigraphy
Technetium
Anatomy

Cite this

White, R. D., Weir-McCall, J. R., Budak, M. J., Waugh, S. A., Munnoch, D. A., & Sudarshan, T. A. P. (2014). Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. Clinical Radiology, 69(11), e435-e444. https://doi.org/10.1016/j.crad.2014.06.007
White, R. D. ; Weir-McCall, J. R. ; Budak, M. J. ; Waugh, S. A. ; Munnoch, D. A. ; Sudarshan, T. A. P. / Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. In: Clinical Radiology. 2014 ; Vol. 69, No. 11. pp. e435-e444.
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abstract = "Chronic lower limb lymphoedema is a debilitating condition that may occur as a primary disorder or secondary to other conditions. Satisfactory visualization of the lymphatic vessels to aid diagnosis and surgical planning has been problematic. Historically, direct lymphography was used to visualize lymphatic vessels, although the significant surgical risks involved led to this being largely abandoned as a technique. Technetium-99m lymphoscintigraphy has been the mainstay of diagnosis for over two decades, but is hampered by inherently poor temporal and spatial resolution and limited anatomical detail. Contrast-enhanced magnetic resonance lymphography (MRL) is a relatively new technique that shows early promise in the evaluation of chronic lymphoedema. This article provides the procedural technique for lower limb MRL at both 1.5 and 3 T, discusses pathophysiology and classifications of lymphoedema, provides an overview of relevant lower limb lymphatic anatomy using MRL imaging, compares the various techniques used in the diagnosis of lower limb lymphoedema, shows common pathological MRL imaging findings, and describes alternative uses of MRL. Utilization of this technique will allow more accurate diagnosis and classification of patients suffering from lymphoedema.",
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White, RD, Weir-McCall, JR, Budak, MJ, Waugh, SA, Munnoch, DA & Sudarshan, TAP 2014, 'Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema', Clinical Radiology, vol. 69, no. 11, pp. e435-e444. https://doi.org/10.1016/j.crad.2014.06.007

Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. / White, R. D.; Weir-McCall, J. R.; Budak, M. J.; Waugh, S. A.; Munnoch, D. A.; Sudarshan, T. A. P. (Lead / Corresponding author).

In: Clinical Radiology, Vol. 69, No. 11, 11.2014, p. e435-e444.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema

AU - White, R. D.

AU - Weir-McCall, J. R.

AU - Budak, M. J.

AU - Waugh, S. A.

AU - Munnoch, D. A.

AU - Sudarshan, T. A. P.

N1 - Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

PY - 2014/11

Y1 - 2014/11

N2 - Chronic lower limb lymphoedema is a debilitating condition that may occur as a primary disorder or secondary to other conditions. Satisfactory visualization of the lymphatic vessels to aid diagnosis and surgical planning has been problematic. Historically, direct lymphography was used to visualize lymphatic vessels, although the significant surgical risks involved led to this being largely abandoned as a technique. Technetium-99m lymphoscintigraphy has been the mainstay of diagnosis for over two decades, but is hampered by inherently poor temporal and spatial resolution and limited anatomical detail. Contrast-enhanced magnetic resonance lymphography (MRL) is a relatively new technique that shows early promise in the evaluation of chronic lymphoedema. This article provides the procedural technique for lower limb MRL at both 1.5 and 3 T, discusses pathophysiology and classifications of lymphoedema, provides an overview of relevant lower limb lymphatic anatomy using MRL imaging, compares the various techniques used in the diagnosis of lower limb lymphoedema, shows common pathological MRL imaging findings, and describes alternative uses of MRL. Utilization of this technique will allow more accurate diagnosis and classification of patients suffering from lymphoedema.

AB - Chronic lower limb lymphoedema is a debilitating condition that may occur as a primary disorder or secondary to other conditions. Satisfactory visualization of the lymphatic vessels to aid diagnosis and surgical planning has been problematic. Historically, direct lymphography was used to visualize lymphatic vessels, although the significant surgical risks involved led to this being largely abandoned as a technique. Technetium-99m lymphoscintigraphy has been the mainstay of diagnosis for over two decades, but is hampered by inherently poor temporal and spatial resolution and limited anatomical detail. Contrast-enhanced magnetic resonance lymphography (MRL) is a relatively new technique that shows early promise in the evaluation of chronic lymphoedema. This article provides the procedural technique for lower limb MRL at both 1.5 and 3 T, discusses pathophysiology and classifications of lymphoedema, provides an overview of relevant lower limb lymphatic anatomy using MRL imaging, compares the various techniques used in the diagnosis of lower limb lymphoedema, shows common pathological MRL imaging findings, and describes alternative uses of MRL. Utilization of this technique will allow more accurate diagnosis and classification of patients suffering from lymphoedema.

U2 - 10.1016/j.crad.2014.06.007

DO - 10.1016/j.crad.2014.06.007

M3 - Review article

VL - 69

SP - e435-e444

JO - Clinical Radiology

JF - Clinical Radiology

SN - 0009-9260

IS - 11

ER -

White RD, Weir-McCall JR, Budak MJ, Waugh SA, Munnoch DA, Sudarshan TAP. Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. Clinical Radiology. 2014 Nov;69(11):e435-e444. https://doi.org/10.1016/j.crad.2014.06.007