dr. abeer fawzy el sobky master degree in radiodiagnosis lymphography
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DR. ABEER FAWZY EL SOBKYDR. ABEER FAWZY EL SOBKY
Master Degree In RadiodiagnosisMaster Degree In Radiodiagnosis
Lymphography
NephrostomyPlacing 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
Radiologically Inserted Gastrostomy
Placement of a feeding
tube percutaneously into
the stomach and/or
jejunum
Vertebroplasty
Percutaneous injection of
biocompatible bone
cement inside fractured
vertebrae
Cryoablation
localized destruction
of tissue by freezing
Biopsy
Taking of a tissue sample
from the area of interest for
pathological examination
from a percutaneous or
transjugular approach
TIPSPlacement of a Transjugular
Intrahepatic Porto-systemic
Shunt (TIPS) for management
of select patients with critical
end-stage liver disease and
portal hypertension
Radiofrequency ablation
(RF/RFA) localized
destruction of tissue (e.g.,
tumors) by heating
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
CONCLUSIONS
Interventional radiology procedures are an advance in medicine that often replace open surgical procedures.
These minimally invasive procedures
involve less blood loss.
Lymphography
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
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).
Anatomy
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.
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.
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.
Disorders of lymphatic system
Lymph ducts (ymphedema)
Primary lymphedema: This is a
vascular dysplasia
Secondary lymphedema:
obstruction to the normal
forward passage of lymph
Lymph nodes
Malignant involvement
Lymph node enlargement due
to infection.
Imaging of lymphatic system
X ray US CT scan MRI Lymphography Lymphoscintigraphy
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.
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
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.
lymphography for lymph vessels
Injection of water-soluble radiological contrast media
No LN opacification
In most cases lymphography can be replaced by lymhangioscintigraphy.
The technique of lymphography in the
edematous leg is difficult, and prior elevation of the limb for 48-72 h may help reduce the amount of limb
edema.
Thank you
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