Describe the technique and evaluate imaging results of the fluoroscopic inguinal intranodal lymphangiography

A retrospective desciptive study was performed on 37 patients who were diagnosed with chylothorax post-operation and underwent intranodal lymphangiography

there were 11 men and 26 women among 37 patients with the mean age was 56. Technical success is defined as the ability to puncture the needle into the inguinal lymph node and inject contrast dye to desptict the main lymphatic vessels from the lumbar to the chest and neck. The success rate of the technique was 100% among all patients. Among the studied patients, a variant anatomy of the main lymphatic vessels was found in 11 out of 27 patients (29%), which included the absence of the cisterna chyli (7/27 patients), absence of the thoracic duct (2/27 patients), and bifurcation of the thoracic duct in the chest region (2/27 patients). The average time to visualize the cisterna chyli or the lower one-third of the thoracic duct was 35.3 ± 20 minutes. No major complications related to the intranodal lymphangiography were reported.

Inguinal intranodal lymphangiography is a safe procedure, provides visualization of central lymphatic anatomy, detected leak points, and guides for percutaneous lymphatic interventions.