Lymfangiografi

Lymfangiografi, or lymphangiography, is a radiographic examination of the lymphatic system in which contrast material is used to opacify lymphatic vessels and lymph nodes. The study traditionally relies on oil-based contrast, most often Lipiodol, injected into lymphatic vessels of the lower extremities or directly into a lymph node. The contrast travels through the lymphatic channels, allowing visualization of the central and peripheral lymphatics on X-ray images.

Techniques commonly employed include pedal (foot) lymphangiography, where small lymphatic vessels are cannulated to deliver contrast, and intranodal lymphangiography, in which ultrasound-guided injection is made into an inguinal lymph node. Imaging is performed over several hours to days to capture the progression of contrast through the lymphatic system. In recent years, magnetic resonance lymphangiography and computed tomography lymphangiography have emerged as less invasive, non-radiation or lower-radiation alternatives, sometimes using intranodal administration of gadolinium-based or other contrast agents.

Indications for lymphangiography include evaluation of lymphedema, assessment of lymphatic obstruction or leaks (for example chylous effusions in the thorax or abdomen), and preoperative planning or localization in certain lymphatic surgeries. It can also aid in mapping lymphatic drainage prior to procedures or in guiding therapeutic interventions such as embolization of leaking lymphatics.

Risks and limitations include the invasive nature of cannulation, potential for infection, inflammatory or oil-related embolic reactions, and exposure to ionizing radiation. In many centers, lymphangiography has been complemented or replaced by MR lymphangiography and other noninvasive lymphatic imaging techniques.