STUDY OF LYMPHANGIOGRAPHY IN UROLOGY
THE LYMPHATIC SYSTEM OF NORMAL PERSONS AND THE METABOLISM OF CONTRAST MEDIUM
1966 Volume 57 Issue 1 Pages 86-112
Details
1966 Volume 57 Issue 1 Pages 86-112
Radiographic determination of lymphatic system has been attempted since 1930, the clinical application of this method has rapidly prevailed after Kinmonth reported it in 1952.
The author studied the lymphatic system by Kinmonth's method on 22 normal persons, and at the same time on several persons with abnormal lymphatic system. Evans blue was injected at the back of the foot, to locate lymph canals. Ten c. c. of DR-47 (manufactured by the Daiichi Pharmacy) was injected into lymph canal of each foot (a total of 20c.c). X-ray films were taken immediately after the injection, and again 24 hours later. Additional films were taken in longer intervals if necessary.
The conclusions are as follows:
1) The X-ray demonstration of the normal lymphatic system is comparatively well incident with the anatomical description. However, it is difficult to show the standard normal picture of this system, as it is so different individually.
2) The majority of films of the normal lymphatic system shows defects in some lymph nodes which might be considered as metastatic pictures. Therefore, these X-ray pictures should be studied very carefully.
3) An investigation was performed for the metabolism of contrast medium using I131. In cases showing normal lymphatic system the contrast medium appeared in the blood 10 minutes after the injection, and 2 1/2 to 6 hours later concentration reached to maximum.
The excretion of contrast medium through urine is 1.5-3.2% on the first day. It gradually decreases thereafter.
4) In the examination using I131, the biological half life of I131 is about 4 days. Therefore it is supposed that the contrast medium in the lymphatic system decreased to half the amount injected in approximately four days.
5) In this method, only a portion of the internal iliac lymphatic system was demonstrated. However, it should be re-emphasized that lymphatic systems of the main pelvic organs are related mainly with external iliac, superior iliac and periaortic lymphatic systems.
6) No serious complications were seen. In order to avoid a large amount of contrast medium entering the blood at once, the injecting speed should be controlled. Serious pulmonary infarction would be avoided by injecting only 20c.c. of contrast medium at one time.
