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Respiratory Medicine Oct 2019A chylothorax, also known as chylous pleural effusion, is an uncommon cause of pleural effusion with a wide differential diagnosis characterized by the accumulation of... (Review)
Review
A chylothorax, also known as chylous pleural effusion, is an uncommon cause of pleural effusion with a wide differential diagnosis characterized by the accumulation of bacteriostatic chyle in the pleural space. The pleural fluid will have either or both triglycerides >110 mg/dL and the presence of chylomicrons. It may be encountered following a surgical intervention, usually in the chest, or underlying disease process. Management of a chylothorax requires a multidisciplinary approach employing medical therapy and possibly surgical intervention for post-operative patients and patients who have failed medical therapy. In this review, we aim to discuss the anatomy, fluid characteristics, etiology, and approach to the diagnosis of a chylothorax.
Topics: Antineoplastic Agents, Hormonal; Chylothorax; Diagnosis, Differential; Exudates and Transudates; Humans; Lymphography; Lymphoscintigraphy; Octreotide; Pleural Effusion; Postoperative Period; Radiography, Thoracic; Suction; Thoracentesis; Thoracic Duct; Tomography, X-Ray Computed; Triglycerides
PubMed: 31454675
DOI: 10.1016/j.rmed.2019.08.014 -
Seminars in Interventional Radiology Aug 2020Lymphangiography as a diagnostic procedure dates back to the 1950s and was widely performed for several decades until being supplanted by other advanced imaging... (Review)
Review
Lymphangiography as a diagnostic procedure dates back to the 1950s and was widely performed for several decades until being supplanted by other advanced imaging techniques. With the advent of thoracic duct embolization to treat chylothorax, Constantin Cope ushered in a transition from lymphangiography as a diagnostic procedure to a precursor for lymphatic intervention. Subsequently, technical modifications and applications of lymphatic embolization to other medical conditions have greatly expanded the scope and application of lymphangiography and lymphatic intervention. Although there is increasing familiarity with lymphatic interventions, few interventionalists have performed a high enough volume to be aware of potential complications and their management. Potential complications of lymphangiography and those encountered while performing lymphatic interventions are discussed along with approaches to minimize their risk and management strategies should they occur.
PubMed: 32773956
DOI: 10.1055/s-0040-1713448 -
Journal of Magnetic Resonance Imaging :... Apr 2023Lymphedema is a devastating disease that has no cure. Management of lymphedema has evolved rapidly over the past two decades with the advent of surgeries that can... (Review)
Review
Lymphedema is a devastating disease that has no cure. Management of lymphedema has evolved rapidly over the past two decades with the advent of surgeries that can ameliorate symptoms. MRI has played an increasingly important role in the diagnosis and evaluation of lymphedema, as it provides high spatial resolution of the distribution and severity of soft tissue edema, characterizes diseased lymphatic channels, and assesses secondary effects such as fat hypertrophy. Many different MR techniques have been developed for the evaluation of lymphedema, and the modality can be tailored to suit the needs of a lymphatic clinic. In this review article we provide an overview of lymphedema, current management options, and the current role of MRI in lymphedema diagnosis and management. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 5.
Topics: Humans; Lymphatic System; Lymphedema; Magnetic Resonance Imaging; Lymphography; Lymphatic Vessels
PubMed: 36271779
DOI: 10.1002/jmri.28496 -
The Journal of Thoracic and... Aug 2018
Topics: Lymphography; Thoracic Duct
PubMed: 29730121
DOI: 10.1016/j.jtcvs.2018.04.032 -
Ugeskrift For Laeger Sep 2022Plastic bronchitis (PB) is a rare disease caused by abnormal lymphatic vessels in the thorax. These vessels drain into the bronchi creating solid casts and potential...
Plastic bronchitis (PB) is a rare disease caused by abnormal lymphatic vessels in the thorax. These vessels drain into the bronchi creating solid casts and potential life-threatening airway obstruction. This is a case report of a 30-year-old man diagnosed with PB after several years of extensive examinations due to symptoms misconceived as non-allergic asthma. We describe the first interventional treatment in Denmark using special T2 weighed MR imaging and dynamic contrast MR lymphangiography with subsequent embolisation of abnormal lymphatic vessels in the thorax.
Topics: Adult; Bronchitis; Humans; Lymphatic System; Lymphatic Vessels; Lymphography; Male; Plastics
PubMed: 36178194
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Nov 2023Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages... (Review)
Review
Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages is mostly insufficient. Therefore-in many cases-surgical procedures, such as to restore lymph flow or excise lymphedema tissues, are the only ways to improve patients' quality of life. Lymphoscintigraphy (LS), near-infrared fluorescent (NIRF) imaging-also termed indocyanine green (ICG) lymphography (ICG-L)-ultrasonography (US), magnetic resonance lymphangiography (MRL), computed tomography (CT), photoacoustic imaging (PAI), and optical coherence tomography (OCT) are standardized techniques, which can be utilized in lymphedema diagnosis, staging, treatment, and follow-up. The combined use of these imaging modalities and self-assessment questionnaires deliver objective parameters for choosing the most suitable surgical therapy and achieving the best possible postoperative outcome.
Topics: Humans; Quality of Life; Indocyanine Green; Coloring Agents; Lymphedema; Lymphography
PubMed: 38004065
DOI: 10.3390/medicina59112016 -
Archives of Plastic Surgery May 2021Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. Volumetric measurements and quality-of-life assessments are...
BACKGROUND
Lymphaticovenular anastomosis (LVA) is a minimally invasive surgical procedure used to treat lymphedema. Volumetric measurements and quality-of-life assessments are often performed to assess the effectiveness of LVA, but there is no method that provides information regarding postoperative morphological changes in lymphatic vessels and veins after LVA. Photoacoustic lymphangiography (PAL) is an optical imaging technique that visualizes the distribution of light-absorbing molecules, such as hemoglobin or indocyanine green (ICG), and provides three-dimensional images of superficial lymphatic vessels and the venous system simultaneously. In this study, we performed PAL in lymphedema patients before and after LVA and compared the images to evaluate the effect of LVA.
METHODS
PAL was performed using the PAI-05 system in three patients (one man, two women) with lymphedema, including one primary case and two secondary cases, before LVA. ICG fluorescence lymphography was performed in all cases before PAL. Follow-up PAL was performed between 5 days and 5 months after LVA.
RESULTS
PAL enabled the simultaneous visualization of clear lymphatic vessels that could not be accurately seen with ICG fluorescence lymphography and veins. We were also able to observe and analyze morphological changes such as the width and the number of lymphatic vessels and veins during the follow-up PAL after LVA.
CONCLUSIONS
By comparing preoperative and postoperative PAL images, it was possible to analyze the morphological changes in lymphatic vessels and veins that occurred after LVA. Our study suggests that PAL would be useful when assessing the effect of LVA surgery.
PubMed: 34024078
DOI: 10.5999/aps.2020.02404 -
RoFo : Fortschritte Auf Dem Gebiete Der... Sep 2019
Topics: Adolescent; Age Factors; Child; Child, Preschool; Chylothorax; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Lymphatic Abnormalities; Lymphatic Vessels; Lymphography; Magnetic Resonance Imaging; Ultrasonography
PubMed: 31430774
DOI: 10.1055/a-0943-1098 -
Microvascular Research Nov 2014Visualization of the lymphatic system is clinically necessary during diagnosis or treatment of many conditions and diseases; it is used for identifying and monitoring... (Review)
Review
Visualization of the lymphatic system is clinically necessary during diagnosis or treatment of many conditions and diseases; it is used for identifying and monitoring lymphedema, for detecting metastatic lesions during cancer staging and for locating lymphatic structures so they can be spared during surgical procedures. Imaging lymphatic anatomy and function also plays an important role in experimental studies of lymphatic development and function, where spatial resolution and accessibility are better. Here, we review technologies for visualizing and imaging the lymphatic system for clinical applications. We then describe the use of lymphatic imaging in experimental systems as well as some of the emerging technologies for improving these methodologies.
Topics: Animals; Contrast Media; Diagnostic Imaging; Homeostasis; Humans; Lymphatic Metastasis; Lymphatic System; Lymphatic Vessels; Lymphedema; Lymphography; Mice; Neoplasm Metastasis; Neoplasms; Positron-Emission Tomography; Radionuclide Imaging; Spectroscopy, Near-Infrared; Tomography, X-Ray Computed; Ultrasonography
PubMed: 24956510
DOI: 10.1016/j.mvr.2014.06.006 -
Cancer Imaging : the Official... Dec 2009Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment.... (Review)
Review
Lymph node metastases are a poor prognostic indicator in many tumours and therefore accurate identification during staging is important prior to commencing treatment. The presence of lymph node metastases can significantly alter patient management and therefore accurate diagnosis of the presence and extent of nodal disease can help optimise patient management. In this review, the radiologic features that aid in the differentiation of malignant and benign lymph nodes are discussed. The keys to successful interpretation on cross-sectional computed tomography (CT) and magnetic resonance imaging of nodal metastases are highlighted. The clinical role of positron emission tomography-CT imaging for nodal staging is discussed and emerging imaging techniques that may further improve nodal staging accuracy are surveyed.
Topics: Adult; Aged; Carcinoma; Contrast Media; Dextrans; Diffusion Magnetic Resonance Imaging; Female; Ferrosoferric Oxide; Humans; Lymphatic Metastasis; Lymphography; Magnetic Resonance Imaging; Magnetite Nanoparticles; Male; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Sensitivity and Specificity; Tomography, X-Ray Computed; Ultrasonography; Young Adult
PubMed: 20080453
DOI: 10.1102/1470-7330.2009.0017