Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

LETTER TO THE EDITOR
Year
: 2011  |  Volume : 21  |  Issue : 2  |  Page : 155-

Interstitial MRI lymphangiography of the lower limbs


Anit Parihar1, Swastika Suvirya2, Suresh Kumar3, Ragini Singh1,  
1 Department of Radiodiagnosis and Imaging, Chhatrapati Shahuji Maharaj Medical University, Chowk Lucknow, Uttar Pradesh - 226 003, India
2 Department of Dermatology, Venereology and Leprosy, Chhatrapati Shahuji Maharaj Medical University, Chowk Lucknow, Uttar Pradesh - 226 003, India
3 Department of General Surgery, Chhatrapati Shahuji Maharaj Medical University, Chowk Lucknow, Uttar Pradesh - 226 003, India

Correspondence Address:
Anit Parihar
Department of Radiodiagnosis and Imaging, Chhatrapati Shahuji Maharaj Medical University, Chowk Lucknow, Uttar Pradesh - 226 003
India




How to cite this article:
Parihar A, Suvirya S, Kumar S, Singh R. Interstitial MRI lymphangiography of the lower limbs.Indian J Radiol Imaging 2011;21:155-155


How to cite this URL:
Parihar A, Suvirya S, Kumar S, Singh R. Interstitial MRI lymphangiography of the lower limbs. Indian J Radiol Imaging [serial online] 2011 [cited 2020 Apr 7 ];21:155-155
Available from: http://www.ijri.org/text.asp?2011/21/2/155/82285


Full Text

Dear Sir,

We read the article "Technical note: MRI lymphangiography of the lower limb in secondary lymphedema" by Kamble et al., published recently in your journal with great interest. [1] We concur with the authors that the investigation of secondary lymphedema has been enigmatic with direct lymphangiography being too invasive and lymphiscintigraphy having poor spatial and temporal resolution. The authors have rightly pointed out that indirect contrast-enhanced MRI lymphangiography offers excellent visualization of the lower limb lymphatics in secondary lymphedema. The greatest advantage of this technique is the absence of radiation exposure, the multiplanar capability of MRI allowing for precise compartmental localization (epifascial/subfascial/intramuscular) and accurate depiction of the extent of abnormality. We would like to point out that one of the major limitations of the technique is poor visualization of inguinal lymph nodes after intradermal injection of contrast in the feet. We would also like to share our experience of indirect MRI lymphangiography with a newer MRI contrast agent with high relaxivity, gadobenate dimeglumine (0.5 mmol/L MultiHance, Bracco, Milano, Italy). We have found gadobenate dimeglumine to provide more detailed depiction of the lymphatic anatomy in the small number of patients that we have done [Figure 1]A and B. Lohrmann et al. have demonstrated frequent visualization of inguinal lymph nodes after injection of gadoteridol (ProHance, Bracco-Altana, Konstanz, Germany) one of the newer contrast agents. [2] The use of newer contrast agents with higher relaxivity thus offers the possibility of simultaneous depiction of the lymphatic channels and the lymph node groups.{Figure 1}

References

1Kamble RB, Shetty R, Diwakar N, Madhusudan G. Technical note: MR Lymphangiography of the lower limb in secondary lymphedema. Indian J Radiol Imaging 2011;21:15-7.
2Lohrmann C, Foeldi E, Bartholomae JP, Langer M. Gadoteridol for MR imaging of lymphatic vessels in lymphoedematous patients: Initial experience after intracutaneous injection. Br J Radiol 2007;80:569-73.