Abstract
Fontan procedure is a surgical procedure used for congenital heart disease with a single ventricular physiology. Lymphatic disorders, including chylothorax, protein-losing enteropathy, and cast bronchiolitis are well-recognized complications of the Fontan procedure. Development of these complications is associated with anatomic abnormalities of the lymphatic system. Noncontrast magnetic resonance lymphangiography （MRL）, a less-invasive imaging approach for the anatomic evaluation of the lymphatic system, has been used in our institution since August 2020. However, obtaining sufficient image quality has been difficult because of the fine structure of the lymphatic vessels, especially in young children. In complex magnetic resonance imaging, including MRL, imaging conditions are typically adjusted during the examination to provide optimal images for clinical purposes. On performing noncontrast MRL in 15 cases up to July 2022, we observed that the imaging quality of the lymphatic vessels compared with the surrounding tissues changed depending on echo time, a key imaging parameter. Analysis of this clinical experience in this study concludes that echo time adjustment constitutes an appropriate imaging approach for MRL. Improving the quality of lymphatic vessel imaging will greatly assist in the evaluation of lymphatic disorders.
