Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility



To evaluate the optimal imaging protocol and the feasibility of intranodal dynamic contrast-enhanced computed tomography lymphangiography (DCCTL) in microminipigs.


The Committee for Animal Research and Welfare provided university approval. Five female microminipigs underwent DCCTL after inguinal lymph node injection of 0.1 mL/kg of iodine contrast media at a rate of 0.3 mL/min with three different iodine concentrations: group 1, 75 mgI/mL; group 2, 150 mgI/mL; and group 3, 300 mgI/mL. The CT values of the venous angle, thoracic duct (TD), cisterna chyli, iliac lymphatic duct, and iliac lymph node were measured; increases in CT values pre- to post-contrast were assessed as the contrast-enhanced index (CEI). Multi-detector row CT (MDCT) and volume rendering images showing the highest CEI were qualitatively evaluated.


The CEI of all lymphatics peaked at 5–10 min. The mean CEI of TD at 10 min of group 2 (193.0 HU) and group 3 (201.5 HU) were significantly higher than that of group 1 (70.7 HU) (p = 0.024). The continuity and overall diagnostic acceptability of all lymphatic system components were better in group 3 (3.6 and 3.0, respectively) than group 1 (2.6 and 1.6) and group 2 (3.0 and 2.6) (p = 0.249 and 0.204).


The optimal imaging protocol for intranodal DCCTL could be dual-phase imaging at 5 and 10 min after the injection of 300 mgI/mL iodinated contrast media. DCCTL provided good images of lymphatics and is potentially feasible in clinical settings.

Key Points

• Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media showed the highest enhancement of all lymphatics at scan delays of 5 and 10 min.

• The optimal iodine concentration for intranodal dynamic contrast-enhanced computed tomography lymphangiography might be 300 mgI/mL.

• Intranodal dynamic contrast-enhanced computed tomography lymphangiography provided good images of all the lymphatic system components and is potentially feasible in clinical settings.

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Fig. 1
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Fig. 4



Cysterna chyli


Contrast-enhanced index


Dynamic contrast-enhanced computed tomography lymphangiography


Dynamic contrast-enhanced magnetic resonance lymphangiography


Iliac lymphatic duct


Iliac lymph node


Thoracic duct


Venous angle


  1. 1.

    Hsu MC, Itkin M (2016) Lymphatic anatomy. Tech Vasc Interv Radiol 19:247–254

    Article  Google Scholar 

  2. 2.

    Lv S, Wang Q, Zhao W et al (2017) A review of the postoperative lymphatic leakage. Oncotarget 8:69062–69075

    Article  Google Scholar 

  3. 3.

    Matsumoto T, Yamagami T, Kato T et al (2009) The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol 82:286–290

    CAS  Article  Google Scholar 

  4. 4.

    Kawasaki R, Sugimoto K, Fujii M et al (2013) Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment. AJR Am J Roentgenol 201:659–666

    Article  Google Scholar 

  5. 5.

    Dori Y, Zviman MM, Itkin M (2014) Dynamic contrast-enhanced MR lymphangiography: feasibility study in swine. Radiology 273:410–416

    Article  Google Scholar 

  6. 6.

    Krishnamurthy R, Hernandez A, Kavuk S, Annam A, Pimpalwar S (2015) Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology 274:871–878

    Article  Google Scholar 

  7. 7.

    Nadolski GJ, Ponce-Dorrego MD, Darge K, Biko DM, Itkin M (2018) Validation of the position of injection needles with contrast-enhanced ultrasound for dynamic contract-enhanced MR lymphangiography. J Vasc Interv Radiol 29:1028–1030

    Article  Google Scholar 

  8. 8.

    Pimpalwar S, Chinnadurai P, Chau A et al (2018) Dynamic contrast enhanced magnetic resonance lymphangiography: categorization of imaging findings and correlation with patient management. Eur J Radiol 101:129–135

    Article  Google Scholar 

  9. 9.

    Chick JFB, Nadolski GJ, Lanfranco AR, Haas A, Itkin M (2019) Dynamic contrast-enhanced magnetic resonance lymphangiography and percutaneous lymphatic embolization for the diagnosis and treatment of recurrent chyloptysis. J Vasc Interv Radiol 30:1135–1139

    Article  Google Scholar 

  10. 10.

    Iwanaga T, Tokunaga S, Momoi Y (2016) Thoracic duct lymphography by subcutaneous contrast agent injection in a dog with chylothorax. Open Vet J 6:238–241

    CAS  Article  Google Scholar 

  11. 11.

    Johnson EG, Wisner ER, Kyles A, Koehler C, Marks SL (2009) Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38:361–367

    Article  Google Scholar 

  12. 12.

    Kim M, Lee H, Lee N et al (2011) Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats. Vet Radiol Ultrasound 52:302–305

    Article  Google Scholar 

  13. 13.

    Dong J, Xin J, Shen W et al (2018) Unipedal diagnostic lymphangiography followed by sequential CT examinations in patients with idiopathic chyluria: a retrospective study. AJR Am J Roentgenol 210:792–798

    Article  Google Scholar 

  14. 14.

    Takasu M, Maeda M, Almunia J, Nakamura K, Nishii N, Takashima S (2018) Response to estrus induction with abortion treatment in microminipigs on different days after insemination. J Reprod Dev 64:361–364

    Article  Google Scholar 

  15. 15.

    Baek Y, Won JH, Kong TW et al (2016) Lymphatic leak occurring after surgical lymph node dissection: a preliminary study assessing the feasibility and outcome of lymphatic embolization. Cardiovasc Intervent Radiol 39:1728–1735

    Article  Google Scholar 

  16. 16.

    Alomari MH, Lillis A, Kerr C, Newburger JW, Quinonez L, Alomari AI (2019) The use of non-ionic contrast agent for lymphangiography and embolization of the thoracic duct. Cardiovasc Intervent Radiol 42:481–483

    Article  Google Scholar 

  17. 17.

    Kariya S, Komemushi A, Nakatani M, Yoshida R, Kono Y, Tanigawa N (2014) Intranodal lymphangiogram: technical aspects and findings. Cardiovasc Intervent Radiol 37:1606–1610

    Article  Google Scholar 

  18. 18.

    Inoue M, Nakatsuka S, Yashiro H et al (2016) Lymphatic intervention for various types of lymphorrhea: access and treatment. Radiographics 36:2199–2211

    Article  Google Scholar 

  19. 19.

    Itkin M (2016) Lymphatic intervention techniques: look beyond thoracic duct embolization. J Vasc Interv Radiol 27:1187–1188

    Article  Google Scholar 

  20. 20.

    Takasawa C, Seiji K, Matsunaga K et al (2012) Properties of N-butyl cyanoacrylate-iodized oil mixtures for arterial embolization: in vitro and in vivo experiments. J Vasc Interv Radiol 23(1215–1221):e1211

    Google Scholar 

  21. 21.

    Wortman JR, Uyeda JW, Fulwadhva UP, Sodickson AD (2018) Dual-energy CT for abdominal and pelvic trauma. Radiographics 38:586–602

    Article  Google Scholar 

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We thank Richard Lipkin, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Correspondence to Yukichi Tanahashi.

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The scientific guarantor of this publication is Yukichi Tanahashi, the corresponding author.

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The Committee for Animal Research and Welfare provided university approval.

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Yukichi Tanahashi and Satoshi Goshima had moved after the study.

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Tanahashi, Y., Iwasaki, R., Shoda, S. et al. Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility. Eur Radiol (2020). https://doi.org/10.1007/s00330-020-07031-0

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  • Lymphangiography
  • Lymphatic system
  • Contrast media
  • Thoracic duct
  • Computed tomography