Itkin Maxim, Nadolski Gregory J
HUP/CHOP Center for Lymphatic Imaging and Interventions, Penn Medicine, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Cardiovasc Intervent Radiol. 2018 Mar;41(3):366-376. doi: 10.1007/s00270-017-1863-2. Epub 2017 Dec 18.
One of the crucial functions of the lymphatic system is maintenance of fluid balance. Nonetheless, due to lack of clinical imaging and interventional techniques, the lymphatic system has been under the radar of the medical community. The recently developed intranodal lymphangiography and dynamic contrast-enhanced MR lymphangiography provide new insight into lymphatic pathology. Thoracic duct embolization has become the method of choice for the treatment of patients with chylous leaks. Interstitial lymphatic embolization further expanded the lymphatic embolization approaches. Liver lymphatic lymphangiography and embolization allow treatment of postsurgical liver lymphorrhea and protein-losing enteropathy. The potential for further growth of lymphatic interventions is vast and includes liver lymphatic procedures and advanced thoracic duct interventions, such as thoracic duct externalization and stenting. These current and future advances will open up a realm of new treatments and diagnostic opportunities.
淋巴系统的关键功能之一是维持液体平衡。然而,由于缺乏临床成像和介入技术,淋巴系统一直未受到医学界的关注。最近开发的淋巴结内淋巴管造影和动态对比增强磁共振淋巴管造影为淋巴病理学提供了新的见解。胸导管栓塞已成为治疗乳糜漏患者的首选方法。间质淋巴管栓塞进一步扩展了淋巴管栓塞方法。肝脏淋巴管造影和栓塞可用于治疗术后肝淋巴漏和蛋白丢失性肠病。淋巴介入治疗进一步发展的潜力巨大,包括肝脏淋巴相关手术以及先进的胸导管介入治疗,如胸导管外置和支架置入。这些当前和未来的进展将开辟一系列新的治疗和诊断机会。