Lymphography: Diagnostic Imaging of the Lymphatic System

Alternative names

Lymphangiography. Lymphographic study.

Definition

Lymphography consists of obtaining radiological images of the lymph nodes and lymphatic vessels that are to be studied using an ionizing radiation emitting source (X-rays), a fluoroscopy or continuous ionizing radiation emitting source, an iodinated contrast medium and / or a colorant, a monitor and a computer.

Sometimes, instead of using a contrast medium to carry out the study, a radiopharmaceutical is used, so we speak of isotopic lymphography.

How is the study done?

The patient should urinate immediately before starting the study.

Lymphography is done in the radiology room of a medical center or hospital by a radiology technician. The patient must undress the anatomical area under study and sometimes a gown will be provided to cover himself; at the same time you should remove your personal items, especially jewelry and metal objects that can interfere with radiological images.

The patient will lie on a table for the administration of the iodinated contrast or the radiopharmaceutical; For this, the technician will carefully disinfect the interdigital spaces of the toes (if you want to study the lower extremities) or the fingers (if you want to study the upper extremities), then proceed to administer a small amount contrast (or sometimes blue dye) after which small lymphatic vessels around the area will appear drawn. The technician will identify two of these vessels (one for each extremity), anesthetize the area and proceed to place a small catheter through which the contrast will be administered slowly. The process can last between 60-90-120 minutes depending on the area to be studied, the technician will be able to assess the correct distribution of contrast through images projected on a monitor from the fluoroscope. After the administration of the contrast, several serial radiographs of the studied lymphatic territory will be taken.

Between 24-48 hours later, the patient must return to the center to have a new series of X-rays taken. The total number of radiographs performed will vary depending on the reasons for which the study is performed and the findings found during the study.

Preparation for the study

The study does not require prior preparation but the signing of an informed consent by the patient will be requested

What does it feel like during and after the study?

The study is painless for the patient except for the discomfort of preparing for the exam and administering the dye (local pain) or contrast (body heat, bad taste in the mouth ...)

In some cases, an allergic reaction to the contrast may occur, in the case of presenting a skin rash, itching or respiratory distress during the study, it should be indicated to the radiology technician immediately.

Depending on the amount of dye used during the study, it can be eliminated in the urine giving it a bluish color during the first 24-48 hours.

Study risks

The lymphographic study, in general, does not imply a significant risk to health.

The type of radiation as well as the dose used follows strict safety controls and in general the benefit obtained outweighs the minimal risks of the radiation itself.

The embryo, fetus, and children are more susceptible to radiation, so in these cases unnecessary studies should be avoided. A pregnant or suspected pregnant woman (including those with an IUD) should avoid the study as much as possible and should tell the radiology technician that she is pregnant before having an X-ray.

The patient may have an allergy to the dye or contrast used during the study. Severe anaphylactic reaction is rare.

A local inflammation / infection may occur in the area of ​​administration of contrast and / or dye a generalized lymphatic infection due to the passage of bacteria through the catheter used during the study. In case of fever after the study, you should consult your doctor immediately.

Study contraindications

The patient should consult with his doctor before carrying out the study in case of:

• Pregnancy and breastfeeding.
• Renal insufficiency
• allergy to the contrast or dye used in the study.
• Take some kind of medication.

What is the study done for?

Lymphography is a widely known and widely used diagnostic test in the field of Angiology. It is especially useful for the diagnosis and monitoring of lymphatic system disorders such as lymphatic insufficiency; at the same time it allows the suspected diagnosis of multiple infectious, inflammatory and / or tumor type pathologies of lymph nodes and lymphatic vessels that must be confirmed later with specific studies.

As it is a complex technique, not exempt from eventual risks, it is usually reserved for very precise indications.