Role of contrast enhanced MRI lymphangiography in evaluation of lower extremity lymphatic vessels for patients with primary lymphedema

Abstract

Evaluating the role of MRI lymphangiography with the intracutaneous injection of gadolinium in the assessment of the lower extremity lymphatic vessels in primary lymphedema. The study was conducted on 20 patients (had 26 affected extremities) with primary lymphedema. All were evaluated by MRI lymphangiography with the intracutaneous injection of gadolinium in the digital web spaces of the feet. The patterns of the lymphatic pathways in the affected lower limbs were classified in this study into five patterns. Pattern (I) was seen in 53.84% (n = 14), pattern (II) was seen in 26.92% (n = 7), pattern (III) was seen in7.69% (n = 2), pattern (IV) was seen in 3.84% (n = 1) and pattern (V) was seen in 7.69% (n = 2) of the affected extremities. MRI lymphangiography with the intracutaneous injection of gadolinium had the potentiality for being the main diagnostic modality in primary lymphedema patients especially those who are candidates for microsurgical reconstruction through providing better visualization of the precise lymphatic anatomy by a feasible, minimally invasive and safe technique.