2021 Volume 37 Issue 2 Pages 134-146
One of the crucial functions of the lymphatic system is maintenance of fluid balance. However, due to a lack of clinical imaging and interventional techniques, the lymphatic system has remained under the radar of the radiology community. The recently developed intranodal lymphangiography and MR lymphangiography have opened the door for lymphatic imaging and intervention.
Lymphatic disorders include lymphedema and lymphorrhea. Among them, idiopathic or secondary lymphatic leakage is a rare condition but can become potentially life-threatening. Postoperative lymphatic leakage is the leading cause of traumatic lymphatic leakage and can arise anywhere within the lymphatic system. Therefore, an appropriate lymphangiography technique is essential for identifying the leakage point.
Recently, interventional radiology has become available for the treatment of lymphatic leaks represented by chylothorax and abdominal lymphatic leakage associated with surgery. In the field of pediatrics, plastic bronchitis and protein losing enteropathy associated with congenital heart disease are also reported to be associated with lymphatic leakage, which can be treated by intervention.
This article comprehensively reviews the clinically relevant lymphatic anatomy, lymphangiography techniques and criteria for their selection, and treatment strategies for various kinds of lymphorrhea.
