The lymphatic system: diagnostic imaging studies (editorial)

Article Abstract:

Common diseases of the lymphatic system are lymphedema and lymphatic metastasis (tumors). A variety of diagnostic methods are available to assess these problems. To date, lymphatic malignancy has been the main target of imaging studies since a large percentage of patients with lymphatic diseases suffer from cancer. Computed tomography (CT) scanning has proven effective in detection of cancerous nodes. New imaging techniques are being evaluated, such as radioactive labeled monoclonal antibodies, but more clinical testing needs to be done before these methods are widely used. A technique that has recently gained notice is lymphoscintigraphy which uses a radioactive contrast agent. Another means of evaluation is interstitial lymphangiography, used to assess the vascular system that works in conjunction with the lymphatic system. This method is only used to study problems that are associated with the lymphatic vascular system. Lymphatic diagnostic techniques have improved in recent years due in part to extensive research in Europe. If they are not used in conjunction with a contrast agent they are incapable of assessing the size of a lymphatic malignancy. Several contrast agents have been developed recently for magnetic resonance (MR) imaging which will increase the usefulness of this diagnostic method. Doctors are waiting for the development of better intravenous contrast agents to specifically target either tumors or normal lymphatic tissue.

Radiography, Medical, Medical radiography, Lymphedema, Medical imaging equipment, Lymphatics, Lymphatic system, editorial

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Hepatobiliary MR imaging: first human experience with MnDPDP

Article Abstract:

Magnetic resonance imaging (MR) can clearly differentiate diseased from normal tissue. However, clinical use of MR for examining the liver has been less successful than other techniques. Problems with the uptake and distribution of contrast agents make it less effective for imaging the liver. This study examined the use of a new MR contrast agent, MnDPDP (a manganese salt), specifically produced for liver MR. Fifty-four subjects were given MnDPDP in varying doses to test its safety, tolerance, and pharmacokinetics. Twelve of the subjects given MnDPDP were also examined using MR. All doses caused some facial flushing and warmth in the head, and a few subjects reported nausea. Blood pressure rises were related to dosage. The MR results showed peak enhancement from the contrast agent after 10 minutes and lasting until 20 minutes later. This length of time is an adequate amount for use in the clinical setting. Enhancement of the images was also shown to be related to dosage given. This is important because manganese salts can be toxic at high dosages. At the levels given in this study, MnDPDP was shown to be an effective contrast agent for MR with little toxic effect. MnDPDP may be a superior contrasting agent for liver MR because of its specificity and its staying time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Liver diseases, Liver

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Extracranial lesions of the head and neck: preliminary experience with Gd-DTPA-enhanced MR imaging

Article Abstract:

Magnetic resonance imaging (MRI) is the noninvasive use of strong magnetic fields and radio frequency energy to produce clear images of internal structures of the body. This study explores the use of Gd-DTPA (gadolinium diethylenetriaminepentaacetic acid) as a contrast material to increase the physicians' ability to differentiate pathologic areas from normal tissue in the head and neck. Twenty-eight patients with known abnormalities of the head and neck were examined by MRI using Gd-DTPA. In some cases the use of Gd-DTPA made a conspicuous increase in contrast between abnormal tissue and surrounding healthy tissues. However, in some cases there was little or no improvement; in no case did GD-DTPA decrease the ability to discern pathology. This agent also resulted in increased signal strength in many normal tissues and acted to enhance normal anatomy. Gd-DTPA is advised for conditions such as: (1) tumors of the sinuses, (2) tumors at the base of the skull and (3) tumors extending into the membranes around the brain (leptomeninges). The use of this material, while in some cases increasing the contrast of structures, was unsuccessful in demonstrating tumors that previously could not be detected without contrast (occult tumors).

Usage, Neck, Head, Diethylenetriaminepentaacetic acid

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