Mesenteric Lymphangiography as a New Diagnostic and Therapeutic Tool for Refractory Chylous Lymphatic Leakages and Protein Losing Enteropathy.

Purpose: This study aims to evaluate whether mesenteric lymphangiography (mLAG) is technically feasible and clinically useful for patients with refractory chylous ascites, chylothorax and protein-losing enteropathy.

Materials And Methods: A retrospective study of 35 patients (M/F 16:19, mean age 56 years, range 20-78) who underwent mLAG at two institutions between March 2016 and July 2022 was performed. mLAG was performed via intraoperative and/or percutaneous approaches.

Combined Percutaneous Sclerotherapy Plus Transarterial Embolization for Refractory Sports Injuries in Young Athletes: A Feasibility Study.

Purpose: To evaluate the feasibility and safety of combined percutaneous sclerotherapy plus transarterial embolization for refractory sports-related tendinopathy in young athletes.

Materials And Methods: Twelve athletes with 20 lesions (13 Achilles tendinopathies, 6 patellar tendinopathies, 1 iliotibial band syndrome), suffering pain persisting >3 months despite conservative management were included. Ultrasound-guided foam sclerosant was injected into the peri-tendinous subcutaneous tissue at the most painful area until approximately 50% pain relief was achieved.

Long-Term Outcomes of Angioplasty and Stent Placement for Portomesenteric Vein Obstruction following Hepatobiliary and Pancreatic Surgery.

Purpose: To evaluate the long-term outcomes of endovascular treatment for postoperative portomesenteric vein (PMV) obstruction and identify prognostic factors influencing patency rates.

Materials And Methods: This retrospective single-center study included patients who underwent endovascular intervention for PMV stenosis or occlusion after hepatobiliary and pancreatic surgery between January 2009 and December 2020. Patient characteristics, technical outcomes, and long-term patency rates were evaluated.

Lymphatic Embolization for Primary Genital Lymphorrhea and Chylous Reflux-Related Lower Limb Lymphedema.

Purpose: To evaluate the safety and effectiveness of lymphatic embolization for primary genital lymphorrhea.

Materials And Methods: A retrospective analysis was conducted on patients who underwent lymphatic embolization for primary genital lymphorrhea and/or lower limb lymphedema between May 2016 and January 2022 at 3 specialized lymphatic centers. Following radiological evaluation of genital lymphorrhea, affected lymphatic vessels were selectively embolized to occlude abnormal lymphatic flow using a mixture of n-butyl cyanoacrylate glue and ethiodized oil.

[Study on the Necessity and Methodology for Enhancing Outpatient and Clinical Education in the Department of Radiology].

In the rapidly evolving healthcare environment, radiologists strive to establish their rightful place. Thus, there is a need for enhanced outpatient and clinical education within the Department of Radiology and exploration of its methodologies. Accordingly, the Korean Society of Radiology established a task force to investigate the clinical and outpatient practice status of radiologists overseas, current state of related education, involvement of other specialties in radiologic practices and education in Korea, and clinical and outpatient practice status among Korean radiologists.

MR Lymphangiography: Congenital Lymphatic Flow Disorders.

Congenital lymphatic flow disorders collectively refer to a heterogeneous group of diseases that manifest as chylothorax, chylous ascites, intestinal lymphangiectasia, protein-losing enteropathy, and peripheral extremity or genital lymphedema, all in the absence of identifiable injury to the lymphatic system. We have only recently begun to understand congenital lymphatic flow disorders through the ability to image lymph flow dynamically. Intranodal dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) is a crucial technique for imaging lymphatic flow in pediatric patients with congenital lymphatic flow disorders.

Hybrid Lymphovenous Anastomosis Surgery Guided by Intraoperative Mesenteric Intranodal Lymphangiography for Refractory Nontraumatic Chylous Ascites: A Case Report.

Refractory chylous ascites can cause significant nutritional and immunologic morbidity, but no clear treatment has been established. This article introduces a case of a 22-year-old female patient with an underlying lymphatic anomaly who presented with refractory chylous ascites after laparoscopic adnexectomy for ovarian teratoma which aggravated after thoracic duct embolization. Ascites (>3,000 mL/d) had to be drained via a percutaneous catheter to relieve abdominal distention and consequent dyspnea, leading to significant cachexia and weight loss.

Novel Interventional Radiology for the Treatment of Various Lymphatic Leakages: Lymphatic Intervention and Embolization.

Little progress has been made in modern lymphatic medicine since Dr. Kinmonth first described pedal lymphangiography in the 1950s. The clinical need for an effective treatment modality for managing lymphatic leakage greatly increased only after intranodal lymphangiography, which enabled the depiction of the exact location of the leakage.

Imaging and Interventions for Lymphatic and Lymphatic-related Disorders.

The lymphatic system is critical in fluid balance homeostasis. Yet, until recently, lymphatic imaging has been outside of mainstream medicine due to a lack of robust imaging and interventional options. However, during the last 20 years, both clinical lymphatic imaging and interventions have shown dramatic advancement.

Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part II. Classification and Treatment of the Lymphatic Disorders.

Lymphatic disorders encompass a broad spectrum of diseases involving the lymphatic system, ranging from traumatic lymphatic leaks to lymphatic malformations. Lymphatic disorders can be categorized into traumatic and non-traumatic disorders according to their etiology. These two categories may be further divided into subgroups depending on the anatomical location of the lymphatic pathology and their association with clinical syndromes.

Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part I. History, Anatomy, Physiology, and Diagnostic Imaging of the Lymphatic System.

Recent advances in lymphatic imaging have provided novel insights into the lymphatic system. Interventional radiology has played a significant role in the development of lymphatic imaging techniques and modalities. Radiologists should be familiar with the basic physiology and anatomy of the lymphatic system to understand the imaging features of lymphatic disorders, which reflect their pathophysiology.

Inadvertent Stenting and Percutaneous Aspiration for Treatment of Adventitial Cystic Disease in the Popliteal Artery: A Case Report.

Adventitial cystic disease (ACD) is a rare, non-atherosclerotic disease that mainly affects the popliteal artery. Treatment is primarily surgical as endovascular approaches are affected by high recurrence rates. However, some studies have reported successful endovascular treatments of popliteal ACD cases.

Noninvasive assessment of foot perfusion in cholesterol-fed rabbits using dynamic volume perfusion CT with an upslope method.

To evaluate the feasibility of dynamic foot volume CT with the upslope method and to demonstrate macrovascular reactivity and microvascular perfusion during cuff-induced reactive hyperemia state in cholesterol-fed rabbits. 30 New Zealand male rabbits were divided into 2 groups: dietary hypercholesterolemia (n = 10) and normal diet control (n = 20). To measure for macrovascular reactivity, perfusion parameters of the left posterior tibial artery was measured at baseline and at reactive hyperemia state.

Transcatheter Dynamic Contrast-Enhanced MR Lymphangiography for Nontraumatic Lymphatic Disorders: Technical Feasibility and Imaging Findings.

This study aimed to evaluate the feasibility and added value of transcatheter dynamic contrast-enhanced magnetic resonance (MR) lymphangiography for nontraumatic lymphatic disorders. Five patients (2 males and 3 females; median age, 16.0 years; range, 3-74 years) who underwent both intranodal and transcatheter dynamic contrast-enhanced MR lymphangiography for suspected nontraumatic lymphatic leakages from June 2017 to January 2020 were included in this retrospective study.

Nontraumatic Chylothorax and Chylopericardium: Diagnosis and Treatment Using an Algorithmic Approach Based on Novel Lymphatic Imaging.

Outcomes of interventional lymphangiographic treatment of nontraumatic chylous pleural effusions using traditional approaches have been highly variable. Recent advances in lymphatic imaging have revealed variations in underlying pathophysiology, enabling improved targeting of therapeutic interventions. To assess outcomes of an algorithm for management of nontraumatic chylous pleural effusions based on advanced magnetic resonance (MR) identification of various abnormalities in the thoracoabdominal lymphatic network that give rise to chylothorax.

Outcomes of Venoplasty-Assisted, Peripherally Inserted Central Catheter Placement in Patients with Upper-Arm Venous Stenosis: Comparison with Midlines and Contralateral Placement.

Purpose: To compare the effectiveness and safety of percutaneous transluminal angioplasty and peripherally inserted central catheter (PTA + PICC), contralateral PICC, and midline catheterization (MC) in patients with venous stenosis.

Materials And Methods: A total of 7,327 PICC procedures were performed in 5,421 patients at a single institution between 2013 and 2019. Among them, 87 patients had upper-arm venous stenoses and were managed with PTA + PICC, contralateral PICC, or MC.

Intranodal CT Lymphangiography with Water-soluble Iodinated Contrast Medium for Imaging of the Central Lymphatic System.

Background Dynamic contrast-enhanced MR lymphangiography (DCMRL) is the reference standard used to diagnose various thoracic lymphatic disorders, such as traumatic chylothorax and plastic bronchitis. However, accessibility and logistical challenges have prevented the wide dissemination of this technology. Purpose To evaluate the feasibility of intranodal CT lymphangiography (ICTL) in the diagnosis and planning of subsequent intervention in patients with thoracic lymphatic disorders.

Anatomic Variations of the Hepatic Artery in 5625 Patients.

Purpose: To analyze the origin and anatomic course of the hepatic arteries by using digital subtraction angiography (DSA) and multidetector CT in a large study sample.

Materials And Methods: This retrospective study included 5625 patients who underwent liver CT and chemoembolization between January 2005 and December 2018 (mean age, 60 years ± 11 [range, 11-99 years]; 4464 males). The CT and DSA images were reviewed to evaluate the visceral arterial anatomy for variations in the celiac axis and hepatic arteries.

Thoracic duct embolization in treating postoperative chylothorax: does bail-out retrograde access improve outcomes?

Objectives: To evaluate clinical outcomes of thoracic duct embolization (TDE) for the management of postoperative chylothorax with the aid of the bail-out retrograde approach for thoracic duct cannulation (TDC).

Materials And Methods: Forty-five patients with postoperative chylothorax underwent Lipiodol lymphangiography (LLG) between February 2016 and November 2019. If targetable central lymphatic vessels were identified in LLG, TDC, a prerequisite for TDE, was attempted.

Prospective Multi-Center Korean Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolics for Nodular Hepatocellular Carcinoma: A Two-Year Outcome Analysis.

Objective: To assess the two-year treatment outcomes of chemoembolization with drug-eluting embolics (DEE) for nodular hepatocellular carcinoma (HCC).

Materials And Methods: This study was a prospective, multicenter, registry-based, single-arm trial conducted at five university hospitals in Korea. Patients were recruited between May 2011 and April 2013, with a target population of 200.