Dynamic contrast-enhanced MR lymphangiography: Feasibility study in swine

Yoav Dori, Menekhem M. Zviman, Maxim Itkin

Research output: Contribution to journalArticle

Abstract

Purpose: To demonstrate the feasibility of dynamic four-dimensional (4D) intranodal contrast material-enhanced magnetic resonance (MR) lymphangiography with inguinal lymph node injection of gadopentetate dimeglumine.

Materials and Methods: All procedures were performed in accordance with the guidelines on the use of animals in research and were approved by the animal care and use committee. Five swine underwent nonenhanced MR lymphangiography with a heavily T2-weighted MR sequence, bilateral inguinal lymph node injection of 2 mL of undiluted gadopentetate at a rate of 1 mL/min, and 60 minutes of MR imaging with T1-weighted high-spatial- And high-temporal-resolution MR angiography. Images were reviewed by a radiologist with expertise in lymphatic imaging and a pediatric cardiac MR imaging specialist for visualization of the thoracic duct (TD). Categorical variables were compared by using the exact conditional McNemar test. A difference with a P value less than .05 was considered significant.

Results: The TD was visualized in three of the five animals (60%) on T2-weighted images. In contrast, the TD was visualized in all five of the animals (100%) after contrast agent injection (P = .25). The median time for flow of the contrast agent through the lymphatic system to the TD outlet was 244 seconds (range, 201-387 seconds). Enhancement was seen in the TD up to 1 hour after injection. All animals survived without any complications.

Conclusion: Dynamic 4D contrast-enhanced MR lymphangiography with intranodal injection of gadopentetate dimeglumine is feasible, produces good images of the central lymphatic system, and demonstrates the time course of flow of contrast agent up the central lymphatic ducts. On the basis of the results of this initial animal experiment, it appears that dynamic 4D contrast-enhanced MR lymphangiography is potentially feasible and safe with commercially available contrast agents.

Original languageEnglish (US)
Pages (from-to)410-416
Number of pages7
JournalRadiology
Volume273
Issue number2
DOIs
StatePublished - Nov 1 2014

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Thoracic Duct
Lymphography
Feasibility Studies
Contrast Media
Magnetic Resonance Spectroscopy
Swine
Injections
Lymphatic System
Gadolinium DTPA
Groin
Lymph Nodes
Animal Care Committees
Magnetic Resonance Imaging
Magnetic Resonance Angiography
Guidelines
Pediatrics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Dynamic contrast-enhanced MR lymphangiography : Feasibility study in swine. / Dori, Yoav; Zviman, Menekhem M.; Itkin, Maxim.

In: Radiology, Vol. 273, No. 2, 01.11.2014, p. 410-416.

Research output: Contribution to journalArticle

Dori, Yoav ; Zviman, Menekhem M. ; Itkin, Maxim. / Dynamic contrast-enhanced MR lymphangiography : Feasibility study in swine. In: Radiology. 2014 ; Vol. 273, No. 2. pp. 410-416.
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abstract = "Purpose: To demonstrate the feasibility of dynamic four-dimensional (4D) intranodal contrast material-enhanced magnetic resonance (MR) lymphangiography with inguinal lymph node injection of gadopentetate dimeglumine.Materials and Methods: All procedures were performed in accordance with the guidelines on the use of animals in research and were approved by the animal care and use committee. Five swine underwent nonenhanced MR lymphangiography with a heavily T2-weighted MR sequence, bilateral inguinal lymph node injection of 2 mL of undiluted gadopentetate at a rate of 1 mL/min, and 60 minutes of MR imaging with T1-weighted high-spatial- And high-temporal-resolution MR angiography. Images were reviewed by a radiologist with expertise in lymphatic imaging and a pediatric cardiac MR imaging specialist for visualization of the thoracic duct (TD). Categorical variables were compared by using the exact conditional McNemar test. A difference with a P value less than .05 was considered significant.Results: The TD was visualized in three of the five animals (60{\%}) on T2-weighted images. In contrast, the TD was visualized in all five of the animals (100{\%}) after contrast agent injection (P = .25). The median time for flow of the contrast agent through the lymphatic system to the TD outlet was 244 seconds (range, 201-387 seconds). Enhancement was seen in the TD up to 1 hour after injection. All animals survived without any complications.Conclusion: Dynamic 4D contrast-enhanced MR lymphangiography with intranodal injection of gadopentetate dimeglumine is feasible, produces good images of the central lymphatic system, and demonstrates the time course of flow of contrast agent up the central lymphatic ducts. On the basis of the results of this initial animal experiment, it appears that dynamic 4D contrast-enhanced MR lymphangiography is potentially feasible and safe with commercially available contrast agents.",
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