CardioVascular and Interventional Radiology

, Volume 42, Issue 3, pp 448–454 | Cite as

Lymphangiography and Post-lymphangiographic Multidetector CT for Preclinical Lymphatic Interventions in a Rabbit Model

  • Tomohiro Matsumoto
  • Kosuke Tomita
  • Shunto Maegawa
  • Takako Nakamura
  • Tetsuya Suzuki
  • Terumitsu HasebeEmail author
Laboratory Investigation Lymphatic
Part of the following topical collections:
  1. Lymphatic



To describe the feasibility of lymphangiography and the visibility of the lymphatic system using post-lymphangiographic multidetector CT (MDCT) for preclinical lymphatic interventions in a rabbit model.

Materials and Methods

Lymphangiography via the popliteal lymph node or vessel after surgical exposure was performed, using six healthy female Japanese White rabbits. Lipiodol was manually injected for lymphangiography. Post-lymphangiographic MDCT examinations were performed in all rabbits. The dataset images were subjected to image processing analysis utilizing the three-dimensional maximum intensity projection technique. Three reviewers evaluated the degree of depiction of the lymphatic system using a four-point visual score (1, poor; 2, fair; 3, good; 4, excellent). The distance between the body surface and cisterna chyli was measured on post-lymphangiographic MDCT axial image.


Lymphangiography was successfully performed in all rabbits. The popliteal lymph node was detectable in 90%. The visualization of lymphatic system via the popliteal node was achieved in 89%. Mean visual scores of > 3.0 were realized by the right femoral lymphatic vessel, left femoral lymphatic vessel, left iliac lymphatic vessel, left lumbar lymphatic trunks and cisterna chyli, whereas mean visual scores of < 3.0 were yielded by the right iliac lymphatic vessel, right lumbar lymphatic trunks and thoracic duct. The distance between the body surface and cisterna chyli on post-lymphangiographic MDCT axial images was 4.33 ± 0.14 cm.


Lymphangiography is feasible, and the visibility of the lymphatic system on post-lymphangiographic MDCT in a rabbit model provides enough information for interventional radiologists to perform preclinical lymphatic interventions.


Lymphangiography Post-lymphangiographic multidetector CT Lymphatic interventions Lipiodol 



We are grateful to Yoshiko Shinozaki and Sachie Tanaka of the Department of Laboratory Animal Science, the Education and Research Support Center, Tokai University for technical support, and staffs of the Department of Radiological Technology, Tokai University Hospital for taking MDCT images.


This work was supported in part by JSPS KAKENHI (Grant No. JP16K19861) and 2015 Tokai University School of Medicine Research Aid.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All applicable international, national and institutional guidelines for the care and use of animals were followed. The study was approved by the institutional Animal Care and Use Committee of Tokai University.

Supplementary material

270_2018_2123_MOESM1_ESM.mp4 (1.5 mb)
Supplemental online material Three-dimensional maximum intensity projection (3D MIP) image on post-lymphangiographic multidetector CT (MP4) showing the lymphatic system in a rabbit. (MP4 1585 kb)


  1. 1.
    Yamagami T, Masunami T, Kato T, Tanaka O, Hirota T, Nomoto T, et al. Spontaneous healing of chyle leakage after lymphangiography. Br J Radiol. 2005;78:854–7.CrossRefGoogle Scholar
  2. 2.
    Kos S, Haueisen H, Lachmund U, Roeren T. Lymphangiography: forgotten tool or rising star in the diagnosis and therapy of postoperative lymphatic vessel leakage. Cardiovasc Intervent Radiol. 2007;30:968–73.CrossRefGoogle Scholar
  3. 3.
    Matsumoto T, Yamagami T, Kato T, Hirota T, Yoshimatsu R, Masunami T, et al. The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol. 2009;82:286–90.CrossRefGoogle Scholar
  4. 4.
    Alejandre-Lafont E, Krompiec C, Rau WS, Krombach GA. Effectiveness of therapeutic lymphography on lymphatic leakage. Acta Radiol. 2011;52:305–11.CrossRefGoogle Scholar
  5. 5.
    Yoshimatsu R, Yamagami T, Miura H, Matsumoto T. Prediction of therapeutic effectiveness according to CT findings after therapeutic lymphangiography for lymphatic leakage. Jpn J Radiol. 2013;31:797–802.CrossRefGoogle Scholar
  6. 6.
    Matsumoto T, Kudo T, Endo J, Hashida K, Tachibana N, Murakoshi T, et al. Transnodal lymphangiography and post-CT for protein-losing enteropathy in Noonan syndrome. Minim Invasive Ther Allied Technol. 2015;24:246–9.CrossRefGoogle Scholar
  7. 7.
    Nadolski GJ, Chauhan NR, Itkin M. Lymphangiography and lymphatic embolization for the treatment of refractory chylous ascites. Cardiovasc Intervent Radiol. 2018;41:415–23.CrossRefGoogle Scholar
  8. 8.
    Cope C, Kaiser LR. Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients. J Vasc Interv Radiol. 2002;13:1139–48.CrossRefGoogle Scholar
  9. 9.
    Inoue M, Nakatsuka S, Yashiro H, Tamura M, Suyama Y, Tsukada J, et al. Lymphatic intervention for various types of lymphorrhea: access and treatment. Radiographics. 2016;36:2199–211.CrossRefGoogle Scholar
  10. 10.
    Johnson OW, Chick JF, Chauhan NR, Fairchild AH, Fan CM, Stecker MS, et al. The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol. 2016;26:2482–93.CrossRefGoogle Scholar
  11. 11.
    Toliyat M, Singh K, Sibley RC, Chamarthy M, Kalva SP, Pillai AK. Interventional radiology in the management of thoracic duct injuries: anatomy, techniques and results. Clin Imaging. 2017;42:183–92.CrossRefGoogle Scholar
  12. 12.
    Pillay TG, Singh B. A review of traumatic chylothorax. Injury. 2016;47:545–50.CrossRefGoogle Scholar
  13. 13.
    Kraitchman D, Kamel I, Weiss C, Georgiades C. Elucidation of percutaneously accessible lymph nodes in swine: a large animal model for interventional lymphatic research. J Vasc Interv Radiol. 2017;28:451–6.CrossRefGoogle Scholar
  14. 14.
    Cope C. Percutaneous transabdominal embolization of thoracic duct lacerations in animals. J Vasc Interv Radiol. 1996;7:725–31.CrossRefGoogle Scholar
  15. 15.
    Lymphography Tjernberg B. An animal study of the diagnosis of Vx2 carcinoma and inflammation. Acta Radiol Suppl. 1962;214:1–184.Google Scholar
  16. 16.
    Rajebi MR, Chaudry G, Padua HM, Dillon B, Yilmaz S, Arnold RW, et al. Intranodal lymphangiography: feasibility and preliminary experience in children. J Vasc Interv Radiol. 2011;22:1300–5.CrossRefGoogle Scholar
  17. 17.
    Gomez FM, Martinez-Rodrigo J, Marti-Bonmati L, Santos E, Forner I, Lloret M, et al. Transnodal lymphangiography in the diagnosis and treatment of genital lymphedema. Cardiovasc Intervent Radiol. 2012;35:1488–91.CrossRefGoogle Scholar
  18. 18.
    Nadolski GJ, Itkin M. Feasibility of ultrasound-guided intranodal lymphangiogram for thoracic duct embolization. J Vasc Interv Radiol. 2012;23:613–6.CrossRefGoogle Scholar
  19. 19.
    Stecker MS, Fan CM. Lymphangiography for thoracic duct interventions. Tech Vasc Interv Radiol. 2016;19:277–85.CrossRefGoogle Scholar
  20. 20.
    Kora S, Urakawa H, Mitsufuji T, Osame A, Higashihara H, Ohki T, et al. Warming effect on miriplatin-lipiodol suspension for potential use as a chemotherapeutic agent for transarterial chemoembolization of hepatocellular carcinoma: in vitro study. Hepatol Res. 2013;43:1100–4.Google Scholar
  21. 21.
    Yang Q, Wang XD, Chen J, Tian CX, Li HJ, Chen YJ, et al. A clinical study on regional lymphatic chemotherapy using an activated carbon nanoparticle-epirubicin in patients with breast cancer. Tumour Biol. 2012;33:2341–8.CrossRefGoogle Scholar
  22. 22.
    Senti G, Kundig TM. Novel delivery routes for allergy immunotherapy: intralymphatic, epicutaneous, and intradermal. Immunol Allergy Clin North Am. 2016;36:25–37.CrossRefGoogle Scholar
  23. 23.
    Itkin M, Nadolski GJ. Modern techniques of lymphangiography and interventions: current status and future development. Cardiovasc Intervent Radiol. 2018;41:366–76.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Department of Radiology, Tokai University Hachioji HospitalTokai University School of MedicineTokyoJapan
  2. 2.Center for Science of Environment, Resources and Energy, Graduate School of Science and TechnologyKeio UniversityYokohamaJapan
  3. 3.Advanced Coating Technology Research CenterNational Institute of Advanced Industrial Science and TechnologyTsukubaJapan

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