1. Dr. ABEER FAWZY EL SOBKY Master Degree In Radiodiagnosis
Lymphography
Dr. ABEER FAWZY EL SOBKY Master Degree In Radiodiagnosis

6. Nephrostomy
Placing a catheter directly into the kidney to drain urine in situations where normal flow of urine is obstructed. NUS catheters are nephroureteral stents which are placed through the ureter and into the bladder

7. Radiologically Inserted Gastrostomy
Placement of a feeding tube percutaneously into the stomach and/or jejunum

8. Vertebroplasty
Percutaneous injection of biocompatible bone cement inside fractured vertebrae

9. localized destruction of tissue by freezing
Cryoablation
localized destruction of tissue by freezing

10. Biopsy
Taking of a tissue sample from the area of interest for pathological examination from a percutaneous or transjugular approach

11. TIPS
Placement of a Transjugular Intrahepatic Porto-systemic Shunt (TIPS) for management of select patients with critical end-stage liver disease and portal hypertension

12. Radiofrequency ablation
(RF/RFA) localized destruction of tissue (e.g., tumors) by heating

13. Biliary intervention
Placement of catheters in the biliary system to bypass biliary obstructions and decompress the biliary system. Also placement of permanent indwelling biliary stents

14. These minimally invasive procedures involve less blood loss.
CONCLUSIONS
Interventional radiology procedures are an advance in medicine that often replace open surgical procedures.
These minimally invasive procedures involve less blood loss.

15. Lymphography

16. Function of lymphatic system
It provides an important pathway for drainage of fluid from cells and tissues back to the bloodstream
It is a vital part of the immune system

17. Components of lymphatic system:
Lymphatic trunks
lymph nodes :
N.B. There are lymphatics within most body tissues (e.g. Lymphatics are not present in brain, spinal cord).

18. Anatomy

19. Anatomical considerations
Lymphatic trunks accompany arteries & veins
Para-aortic lymphatic trunks empty into the cisterna chyli (L2 level)
Passing up through the diaphragm to become the thoracic duct
Terminates by anastomosing with the left subclavian vein.
Smaller right lymphatic trunk drains into the right subclavian vein.

20. Anatomical considerations
Valves within the lymphatics
The combination of
filtration pressure
movement of the limbs and muscles
contraction of the smooth muscle fibers within the walls of lymphatic trunks.
Lymph drainage is about 2.5 L/day.

21. Lymph nodes Ecapsulated aggregates of lymphatic tissue, Bean shaped
In the path of the lymphatic vessels
Size from microscopic to 2 cm
Hilum
Number approximately 600.
Approximately 300 in the neck.

22. Disorders of lymphatic system
Lymph ducts (ymphedema)
Primary lymphedema: This is a vascular dysplasia
Secondary lymphedema: obstruction to the normal forward passage of lymph

23. Lymph nodes Malignant involvement
Lymph node enlargement due to infection.

24. Imaging of lymphatic system
X ray US
CT scan
MRI
Lymphography
Lymphoscintigraphy

25. lymphography
Sensitive test that studies the lymphatic ducts and the internal architecture of nodes
Follow-up imaging of nodal diseases as the contrast persists in lymph nodes for 6-12 months.

26. Lymphography only examines lymph nodes and ducts in the drainage pathway from the legs or arms.
Successful lymphography is a difficult procedure for patient and operator

27. Technique
The small lymphatic ducts in the foot must be cannulated using a cut-down procedure;
Oily contrast media is then slowly injected
Radiographs taken
Immediately
After at least 24 h delay to demonstrate the lymph nodes.

28. lymphography for lymph vessels
Injection of water-soluble radiological contrast media
No LN opacification
In most cases lymphography can be replaced by lymhangioscintigraphy.

29. The technique of lymphography in the edematous leg is difficult, and prior elevation of the limb for h may help reduce the amount of limb edema.

34. Thank you