1

Lymphatic System:Green-superficialBlack- deep

2

RT AND LT LYMPH DRAINAGE

3

LYMPH DRAINAGE

4

Lymphography• General term applied to the radiologic examination of:

– Lymph nodes – Lymph Vessels

• Usually done to demonstrate pelvis and abdomen– Injected in foot

• For axillary, clavicular area and upper limbs– Injected in hand

• Checks drainage of lymph nodes

5

Pre Procedure

• Obtain PT history

• Obtain PT consent

• Make sure to have all supplies

• Positioning aides and comfort supplies

6

Procedure

• Inject blue dye under skin in between toes

• Inject small amount of contrast into the lymph vessels– Show blue tint

• Nodes in pelvis and abdomen are demonstrated with foot injection

7

Procedure

• X-rays are usually taken 1 HR after injection– 24 hrs– 48 hrs (if needed)– 72hrs (if needed)

• First hour– Contrast in lymph ducts

• 24 hours – If lymph nodes

• After 24 hours it is indicative of cancer

8

Post Procedure

1. Watch for signs of infection Swelling red and warm to touch Accompanied by a fever Contact DR right away

2. Drink lots of water

3. Major swelling in one limb Especially limb injected

9

Indications• Check for

metastasis

• Edema in limbs– Obstruction

• Infections

• Rule out cancer

10

Contrast

• Oil based – More commonly used– Ethiodal– Lipodal

• Water based Iodine– Less commonly used– Ionic– Non-ionic

11

Iliopelvic-aortic Lymphatic System

12

Iliopelvic Abdominoaortic Lymph Nodes

13

Inguinal Region

14

Lymphography

15

Upper Limb Lymphography