MRI evaluation of lymphatic circulation in Fontan patients
DOI:
https://doi.org/10.37615/retic.v7n2a15Keywords:
lymphography, protein-losing enteropathy, plastic bronchitisAbstract
Fontan surgery has improved the prognosis of patients with single ventricle physiology; however, lymphatic complications (plastic bronchitis and protein-losing enteropathy) are responsible for significant morbidity and mortality. The elevation of venous pressure that results after the Fontan completion cause lymphatic congestion and thoracic duct dilation, that can end with lymphatic fistulas into the bronchial tree, the duodenum, ascites or edemas. Dynamic and static techniques with MRI are currently being implemented for the diagnosis and treatment of these conditions. The fat-saturated T2-weighted turbo spin echo sequence is a fast and high-resolution sequence that allows the stratification of lymphatic alterations in 4 grades. Stages 3 and 4 are related with worse outcomes after Fontan completion.
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Dori Y. Novel Lymphatic Imaging Techniques, Techniques in Vascular and Interventional Radiology. https://doi.org/10.1053/j.tvir.2016.10.002 DOI: https://doi.org/10.1053/j.tvir.2016.10.002
Dori Y, Keller MS, Fogel MA, Rome JJ, Whitehead KK, Harris MA and Itkin M. MRI of Lymphatic Abnormalities After Functional Single-Ventricle Palliation Surgery. AJR 2014; 203:426–431. https://doi.org/10.2214/AJR.13.11797 DOI: https://doi.org/10.2214/AJR.13.11797
Biko DM, DeWitt AG, Pinto EM, Morrison RE, Johnstone JA, Heather Griffis H et al. MRI Evaluation of Lymphatic Abnormalities in the Neck and Thorax after Fontan Surgery: Relationship with Outcome. Radiology 2019; 291:774–780. https://doi.org/10.1148/radiol.2019180877 DOI: https://doi.org/10.1148/radiol.2019180877
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Copyright (c) 2024 Itziar García-Ormazábal, Jesús Javier Martín-Pinacho, Javier Alarcón Rodríguez, María Jesús Cerro Marín
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