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At least 271 records · Page 15Linked to original sources

Interstitial MR and CT lymphography with Gd-dTPA-co-alpha, omega-diaminoPEG(1450) and Gd-dTPA-co-1,6-diaminohexane polymers: preliminary experience.

RATIONALE AND OBJECTIVES: The authors assessed the efficacy of two gadolinium-based polymers used as lymphotrophic contrast media for computed tomography (CT) and magnetic resonance (MR) imaging. MATERIALS AND METHODS: Two gadolinium-based polymers, gadolinium diethylenetriaminepentaacetic acid (DTPA)-co-1,6-diaminohexane (NC 22181) and Gd-DTPA-co-alpha, omega-diamino-polyethylene glycol(1450) (NC-66368), were formulated at a concentration of 80 mmol/L gadolinium. Doses of 0.1, 0.25, 1.0, or 2.0 mL per paw were administered subcutaneously into the hindpaws of normal rabbits. Spin-echo T1-weighted MR imaging (1.5 T) of rabbit popliteal and iliac nodes was performed before and immediately, 10 minutes, 2-3 hours, and 24 hours after injection. CT was performed 2-3 hours after injection of the high doses only. RESULTS: MR imaging revealed prompt enhancement of the popliteal nodes with both polymers at doses of 0.25 mL and above. For doses of 1.0 mL or less per paw, nodal percentage enhancement was maximal at 2 hours and then declined at 24 hours. At the highest doses, however, a reservoir of subcutaneous contrast material remained at the injection site and resulted in peak enhancement at 24 hours. At CT, popliteal node enhancement was faintly visible 2-3 hours after the administration of NC 22181. At lower doses, no enhancement was appreciable at CT. CONCLUSION: At 80 mmol/L formulations, the two gadolinium-based polymers provide excellent popliteal nodal enhancement on MR images. In addition, high doses of one polymer (NC 22181) were sufficiently concentrated in popliteal nodes to be visible on CT scans. Thus, this agent may be useful for both CT and MR lymphography.

Animals↗

[Contrast retention in retroperitoneal lymph nodes after lymphography; the effect of lymph node abnormalities, radiotherapy and contrast quantity].

The rate of contrast loss from retroperitoneal lymph nodes after lymphography was studied radiologically over a prolonged period in 302 patients. It varied remarkably, even in normal persons who were not receiving any treatment. Lymph nodes empty more quickly if only a small quantity of contrast has been used. Irradiation accelerates contrast transport, not only in the irradiated, but also in the neighbouring, group of nodes. This effect is dose dependent. There is evidence that pathological lymph nodes empty more quickly than normal ones.

Adult↗

[Lymphography in malignant ovarian tumours (author's transl)].

21% of 81 patients with malignant neoplasms of the ovaries had lymphographic evidence of metastases in regional iliac and aortic lymph nodes. The frequency of lymphatic metastases in various stages was approximately the same (FIGO stage I = 17%, II = 21%, III = 19%). About one fifth of patients therefore had to be restaged. Lymphography should be used for staging routinely, even if a laparotomy is planned.

Adenocarcinoma, Mucinous↗

[Lymphography for the prognosis of carcinoma of the cervix (author's transl)].

Ninety-two patients with carcinoma of the cervix, who had lymphograms before treatment, were observed for a period of three to five years. In patients with lymph node metastases 57.1% were found to have recurrences or metastases, or died during that period. Amongst patients with normal lymphograms the corresponding figure was 11.3%. These findings were true for each stage of the disease. Follow-up studies with histological examination of the lymph nodes have shown that the prognosis of carcinoma of the cervix is totally different if lymph node metastases are present. Separation into cases with good and bad prognosis can be achieved by pre-treatment lymphography. The radiological findings concerning lymph nodes should therefore be included in the classification of carcinoma of the cervix; the T.N.M. calssification of U.I.C.C. makes this possible.

Female↗

[Studies on the diagnostic accuracy of lymphography (author's transl)].

Contradictory reports in the literature on the reliability of lymphography stimulated the authors to test the diagnostic accuracy, employing methods which are approximately analogous to practice, using carcinoma of the cervix as the model on which the study was carried out. Using 21 observers it was found that there was no correlation between their experience and on-target accuracy of the diagnosis. Good observers obtained an accuracy of 85% with good proportions between sensitivity in the recognition of detail, specificity and readiness to arrive at a decision on the basis of discriminatory ability. With the help of the concept of the ROC curves, the position taken up by the observers in respect of diagnostic decisions, and a complex manner of assessing the various characteristic factors determining diagnostic accuracy, are demonstrated. This form of test, which permits manipulation of different variants of diagnosis, is recommended, among other things, for performance control at the end of training and continuing education courses in other fields of x-ray diagnosis as well.

Female↗

Postirradiation changes on the lymphatics studied by lymphography.

Repeat lymphography was done in 33 patients following radiotherapy between 8--73 months. Absorbed dose delivered by 60Co-teletherapy ranged between 30--45 Gy-s in subdiaphragmatic and 30,6--56 Gy-s in mediastinal region. The main sequel of radiation was decrease in nodal size (66,6%), lumen narrowing of lymphatic vessels (51,5%); number of lymph nodes and lymph vessels diminished rarely (6%). Blocking of lymph circulation never developed. Dilatation of thoracic duct with accelerated contrast flow rate was thought to be arteficial due to decreased pooling capacity of decreased nodal size. Radiation induced changes develop within 12 months and do not progress further on. It is concluded that changes are mainly affected by the level of absorbed dose.

Adolescent↗

[The value of lymphography of malignant testicular tumors].

Between 1965 and 1968, 6500 lymphograms were performed at the University of Göttingen. Amongst these, there were 412 patients with malignant testicular tumours. In 81 patients the results of lymphography could be checked histologically. There was agreement between the lymphographic and histological findings in 65 patients (80.3%), sensitivity of 98.1% (51 out of 52) and specificity of 48.3% (14 out of 29). In 50 patients CT was performed in addition. The findings agreed in 31 cases; in eight patients lymphangiography resulted in a false positive finding and CT was incorrect in 12 patients. In all patients with proven retroperitoneal metastases, one or the other method produced a correct diagnosis.

Adult↗

[Indirect lymphography: indications, technic, clinical results].

Indirect lymphography with iotrolan makes it possible to demonstrate the lymphatic pathways with minimal invasiveness. This opens up new possibilities in the differential diagnosis of chronic swelling of the extremities. The typical radiological appearances make it possible to diagnose various types of lymphoedema and lymphangiomatous malformations. The method also promises to be useful in elucidating the pathogenesis of various types of swelling of the extremities.

Adolescent↗

[1st report on indirect lymphography using iotasul in the head and neck region].

The early results in 29 patients with tumours in the head and neck are described, on whom indirect lymphography with the water-soluble contrast medium Iotasul had been carried out (experimental contrast medium, Schering AG). After careful sub-epidermal injection of about 12 ml contrast, either lateral to the eye or in the region of the chin, lymph vessels were seen in 25 patients and lymph nodes in 20. These were demonstrated by conventional radiography or by xero-radiography. There were no local or generalised reactions.

Contrast Media↗

[Indirect lymphography at the eye and in the face- and neck-region with iotasul (author's transl)].

For the first time the lymphatic pathways of the conjunctiva and the eyelids of dogs could be presented in vivo with the water-soluble X-ray contrast medium iotasul. By means of indirect application the lymph flow could be demonstrated up to the truncus jugularis. Because of the simultaneous infusion of the contrast medium at different points the lymphography of the face- and neck-region is considerably facilitated.

Animals↗

Percutaneous transhepatic lymphography method to image and treat intra-abdominal lymph node metastasis in patients with unresectable hepatobiliary pancreatic cancer.

BACKGROUND: There have been no effective treatments for intra-abdominal lymph node metastasis. One of the main reasons is that we cannot deliver chemotherapeutic agents directly. We evaluated percutaneous transhepatic lymphography (PTL) as a drug delivery system. METHODS: PTL was performed 16 times in 13 patients. PTL was performed by puncture of the intrahepatic periportal area. Immediately after injection of contrast medium, lymphatic flow through the hepatoduodenal ligament to the intra-abdominal lymph nodes was visualized. The chemotherapeutic agent was delivered to the metastatic intra-abdominal lymph nodes by this route. RESULTS: In 10 of 13 patients, intrahepatic and extrahepatic lymphatic vessels and lymph nodes were visualized by PTL. Computed tomography after PTL showed retention of lipiodol in the lymphatic system around the portal vein and in the enlarged metastatic lymph nodes located in the pancreatic and celiac lymph nodes. According to the Response Evaluation Criteria in Solid Tumors, there were 8 patients with progressive disease and 5 with stable disease. CONCLUSIONS: The present study showed that PTL can be used as a drug delivery system specific for intra-abdominal lymph nodes as well as for identification of the lymph tracts.

Aged↗

Interstitial CT lymphography-guided localization of breast sentinel lymph node: preliminary results.

BACKGROUND: Accurate localization of the breast sentinel lymph node (SLN) can be challenging as a minimally invasive approach to the treatment of early-stage breast cancer. We tested the potential capability of interstitial computed tomographic lymphography (CT-LG) using a conventional contrast agent (iopamidol) for SLN mapping. METHODS: In 14 female dogs, 0.5 and 1 mL of undiluted iopamidol was injected subcutaneously into the 2 skin areas overlying the mammary gland. Contiguous, 2 mm-thick multidetector helical CT images were obtained through the upper breast and axilla before, and for 60 minutes after, gentle massage at the injection site. Three-dimensional (3D) CT images were obtained from the postcontrast images showing the greatest SLN enhancement. This CT-LG with 2 mL of iopamidol was also evaluated in 5 human female volunteers. RESULTS: The direct connection of SLN and lymphatic vessels draining from the injection sites in the animal models was clearly visualized, even with 0.5 mL of iopamidol. With this dose, the SLN attenuation was maximally enhanced, with a mean of 274 Hounsfield units (HU) on the first postcontrast images. The topographic 3D images provided the comprehensive anatomy of these lymphatic pathways. Of the 28 SLNs and 184 distant nodes visualized on CT images, all of the SLNs (100%) and 161 (87.5%) of the distant nodes could be resected at premortem and/or postmortem, with a good correlation in the locations and sizes with those on the CT images. The CT-LG effectively localized 5 SLNs with averaged maximum attenuation of 223 HU in the human volunteers, without any significant adverse effects. CONCLUSION: Interstitial CT-LG using small volumes of iopamidol can sufficiently visualize breast lymphatic drainage and may have potential utility for breast SLN mapping.

Adult↗

Evaluation of perfluoroctylbromide for lymphography in the dog: comparison with ethiodol.

The efficacy and safety of perfluoroctylbromide as a diagnostic contrast agent for direct lymphography was studied in mongrel dogs. This radiopaque perfluorocarbon has several advantages over Ethiodol. The liquid compound has injection times one-fifth of that required for Ethiodol. When dosages were three to four times that necessary for radiograms, the lungs of perfluoroctylbromide dogs tolerated the increase better than the Ethiodol dogs. Although the radiopacity is less, radiographs were acceptable. The less radiopacity of the fluoroctylbromide nodes may be of greater significance in the larger body of the human.

Animals↗

Characterization of reactive versus tumor-bearing lymph nodes with interstitial magnetic resonance lymphography in an animal model.

RATIONALE AND OBJECTIVES: To determine if magnetic resonance lymphography performed with subcutaneously administered AMI-227, a nanoparticulate iron oxide contrast agent, can distinguish reactive from tumor-bearing lymph nodes. MATERIALS AND METHODS: Mature male Copenhagen rats were inoculated with cell suspensions of R3327-MAT-LyLu rat prostate carcinoma (n = 21) or Freund's complete adjuvant (n = 15) in the left footpad to generate ipsilateral popliteal lymph node metastases or lymphadenitis. At 12 to 14 days after inoculation, T1-and T2-weighted magnetic resonance images of bilateral popliteal areas were obtained before and 24 hours after subcutaneous administration of AMI-227. Contrast-to-noise ratios were calculated in precontrast and postcontrast images. Bilateral popliteal nodes were excised for pathologic assessment. RESULTS: AMI-227 resulted in decreased contrast-to-noise ratios in reactive (T1-W = -7.01 +/- 1.13, T2- W = -31.64 +/- 5.35) and normal (T1 - W = -13.56 +/- 1.97, T2 - W = -21.62 +/- 2.51) nodes. Contrast-to-noise ratios were unchanged (T1 - W = -0.22 +/- 1.71, T2 - W = -2.20 +/- 4.19) in tumor-containing nodes. These differences in contrast-to-noise ratio changes between tumor-bearing versus nontumor-bearing nodes were statistically significant (P < 0.05). Histologic analysis showed similar distribution of AMI-227 within normal and reactive nodes, but not in tumor-bearing nodes. CONCLUSIONS: Differences in AMI-227-uptake between tumor- and nontumor-bearing nodes detected with magnetic resonance imaging are helpful for distinguishing the two entities.

Animals↗

Visualization of breast lymphatic pathways with an indirect computed tomography lymphography using a nonionic monometric contrast medium iopamidol: preliminary results.

RATIONALE AND OBJECTIVES: The capability of an indirect computed tomographic lymphography (CT-LG) using a nonionic monometric contrast medium iopamidol for visualizing breast lymphatic pathways was preliminarily tested. MATERIALS AND METHODS: In 10 female dogs, a total of 0.5 and 1 mL of undiluted iopamidol was injected subcutaneously into the skin areas overlying the both caudal mammary glands. Contiguous 2-mm-thick multidetector raw helical CT images were obtained through the upper thorax and axilla before and during 60 minutes after gentle massage at the injection sites, with reconstruction into three-dimensional (3D) postcontrast CT images. The first lymph node (1st LN) directly draining from the injection sites was marked under CT guidance, followed by pre- and postmortem examinations. This CT-LG with 2-mL iopamidol was also attempted in five human female volunteers. RESULTS: Even with 0.5-mL iopamidol, the CT-LG clearly visualized the direct connection of the 1st LN and lymphatic vessels draining from the injection sites throughout the examination time in all the animals, with the maximum CT attenuation of 269 Hounsfield units (HU) +/- 137 in the 1st LN on the first postcontrast images. The topographic 3D images provided comprehensive anatomic outlines of these lymphatic pathways. Of the total of 20 opacified 1st LN and 110 distant nodes, all the 1st LN (100%) and 92 (83.6%) distant nodes could be resected at pre- or postmortem, with a good correlation with the CT images. The CT-LG also effectively localized the 1st LN with the maximum attenuation of 223 HU +/- 63 in the human volunteers, without any significant late adverse effects. CONCLUSION: Indirect CT-LG with iopamidol may have excellent potential for visualizing breast lymphatic drainage and for preoperative localization of breast sentinel lymph nodes.

Adult↗

Hepatic oil embolism following lymphography: CT diagnosis.

Hepatic oil embolism following lymphography is reported in a 68-year-old man admitted for chylous ascites associated with recurrent prostatic carcinoma. Abdominal plain radiography, CT, and ultimately liver biopsy strongly support a direct lymphatic pathway and are against the role of lymphaticovenous anastomoses generally advocated to explain this phenomenon.

Aged↗