Huhndorf Monika, Langguth Patrick, Seoudy Hatim, Jansen Olav, Uebing Anselm, Hansen Jan Hinnerk, Voges Inga
Department of Radiology and Neuroradiology, University Hospital Schleswig- Holstein, Kiel, Germany.
Department of Internal Medicine III, Cardiology and Critical Care, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
BMC Med Imaging. 2025 Jul 1;25(1):229. doi: 10.1186/s12880-025-01803-0.
Single ventricle (SV) Fontan patients are at risk for the development of pathological cervicothoracic lymphatic drainage pathways that are involved in the development of serious conditions such as plastic bronchitis or chylothorax. Visualization and categorization of cervicothoracic lymphatic drainage pathways might therefore help to stratify prognosis and to individualize therapy and follow-up for Fontan patients. This study aimed to show that the 3-dimensional (3D) modified Dixon (mDixon) steady state magnetic resonance (MR) angiography, commonly used to image cardiovascular anatomy, can visualize cervicothoracic lymphatic drainage pathways in high resolution in Fontan patients.
3D mDixon steady state MR angiography of 88 pediatric and young adult patients with a Fontan circulation were retrospectively analysed. The pattern of cervicothoracic lymphatic pathways and image quality according to diagnostic value were assessed. Furthermore, ventricular volumes, mass and ejection fraction from cine imaging were measured.
Image quality was assessed as very good or good in > 90% of the cases. Six patients had a lymphatic complication of which five (83.3%) had a higher cervicothoracic lymphatic pathway type (type 3 or 4).
3D mDixon steady state MR angiography is an established method to assess cardiovascular anatomy and function in Fontan patients. The method also allows to visualize and evaluate the cervicothoracic lymphatic anatomy with high image quality. 3D mDixon steady state MR angiography is therefore particularly useful to comprehensively assess Fontan patients, a patient group prone not only to cardiac but also lymphatic failure.
单心室（SV）Fontan手术患者存在病理性颈胸淋巴引流途径形成的风险，这些途径与诸如塑料支气管炎或乳糜胸等严重疾病的发生有关。因此，颈胸淋巴引流途径的可视化和分类可能有助于对Fontan手术患者的预后进行分层，并使治疗和随访个体化。本研究旨在表明，常用于心血管解剖成像的三维（3D）改良Dixon（mDixon）稳态磁共振（MR）血管造影能够以高分辨率显示Fontan手术患者的颈胸淋巴引流途径。
对88例患有Fontan循环的儿科和年轻成人患者的3D mDixon稳态MR血管造影进行回顾性分析。评估颈胸淋巴途径的模式以及根据诊断价值评估图像质量。此外，测量电影成像中的心室容积、质量和射血分数。
超过90%的病例图像质量被评估为非常好或良好。6例患者出现淋巴并发症，其中5例（83.3%）具有较高的颈胸淋巴途径类型（3型或4型）。
3D mDixon稳态MR血管造影是评估Fontan手术患者心血管解剖结构和功能的成熟方法。该方法还能够以高质量图像显示和评估颈胸淋巴解剖结构。因此，3D mDixon稳态MR血管造影对于全面评估Fontan手术患者特别有用，这是一个不仅易发生心脏衰竭而且易发生淋巴衰竭的患者群体。
