Kikke Stacy,  Ritze Kimberly

Final Pr. ID: Poster #: CR-003 (T)

The purpose of this submission is to educate technologists in performing magnetic resonance (MR) lymphangiography in conjunction with intranodal gadolium contrast injection in the pediatric patient. MR lymphangiography is a new procedure in the pediatric population. The lymphatic system plays the important role of transporting fluid from tissue back into the venous system via lymphovenous connections. Despite this key role, there has been a poor understanding of lymphatic flow physiology. The recent development of dynamic contrast intranodal MR lymphangiography, which provides quick and reliable access to the central lymphatic system, has provided insight into understanding the pathophysiology of several lymphatic flow disorders and provides guidance for interventional procedures. It also makes it possible to see central lymphatic anatomy with high spatial and temporal resolution. This allows clinicians to map the anatomy of the lymphatic system to determine the location of lymphatic leaks. MR lymphangiography may reduce the need for conventional IR lymphangiogram and spare patient’s radiation exposure. Read More

Authors:  Kikke Stacy , Ritze Kimberly

Keywords:  mrI, lymphangiography, abdominal

Aamir Asmaa,  Bailey Smita

Final Pr. ID: Poster #: CR-007

Protein- losing enteropathy (PLE) is a serious complication that can occur after the Fontan operation. Increased systemic venous pressure can cause altered mesenteric circulation, lymphangiectasis, and enteric protein loss. PLE can cause significant morbidity with hypoalbuminemia, coagulation abnormalities and hypogammaglobulinemia. Dynamic contrast- enhanced (DCE) MR lymphangiography (MRL) is a minimally invasive technique that has emerged as a valuable tool for imaging lymphatic flow and lymphatic disorders. DCE MRL can aid in the localization of lymphatic leak in the intestinal lumen. The purpose of this presentation is to review the technique of DCE MRL for evaluation of protein- losing enteropathy along with the imaging findings.
We present a 12 year old female with congenital heart disease including single ventricle, heterotaxy with dextrocardia. She had a bilateral bidirectional Glenn procedure complicated by prolonged chylous effusion requiring thoracic duct ligation and pleurodesis. She underwent non-fenestrated extracardiac Fontan which was complicated by protein-losing enteropathy. Lymphatic embolization was done however she developed recurrent PLE. DCE MRL demonstrated leakage of contrast in the duodenum and proximal jejunum. She underwent thoracic duct decompression procedure which resulted in significantly improved symptoms. Read More

Authors:  Aamir Asmaa , Bailey Smita

Keywords:  MRI Lymphangiography, Abdomen