Imaging manifestations of lymphatic obstruction

Lymphography can be used to judge whether there is lymphatic obstruction and determine the location of obstruction, which is of great help to clinical diagnosis and treatment. When analyzing the results of lymphangiography, we must pay attention to the number, behavior, contour, diameter and valve condition of lymphatics. The common X-ray signs of lymphatic obstruction are summarized as follows. The appearance of lymphatic collateral pathway is one of the most common signs of lymphatic obstruction, and it is also the main way for the body to overcome obstruction. There are two basic forms of lateral communication of lymphatic vessels.

① Lymphatic vessel anastomoses with vein: Contrast agent was found in vein in lymphatic obstruction area. It proves that there is lymphatic vein anastomosis. Lymphography usually cannot directly see the path.

② Lymphatic anastomosis: It is the most common collateral pathway, similar to collateral circulation after vascular occlusion. For example, when the lumbar lymph is completely blocked, the contrast agent is diverted to the opposite side through the communicating lymphatic vessels at the bifurcation of the aorta, showing the trunk of the opposite lumbar lymph. If the obstruction is located in groin or inferior iliac region, it can show a wide range of subcutaneous collateral lymphatic pathways in perineum, external genitalia and anterior abdominal wall of thigh.