Lymph is an indispensable immune tissue in the body. When blockage occurs, toxic gases will accumulate in the body, causing serious effects on a person's body. Most of the time, lymphatic blockage is caused by the patient's failure to treat lymph node enlargement in time. At the same time, lymphatic blockage may also be a metastatic lesion of other diseases in the body. Let’s take a look at the causes of lymphatic blockage. There are many causes of lymphatic obstruction, which can be divided into primary (unknown cause) and secondary. Secondary causes include inflammation, tumors, injury, and radiotherapy. Imaging findings Lymphangiography can be used to determine whether lymphatic vessel obstruction occurs and to identify the site of obstruction, which is very helpful for clinical diagnosis and treatment. When analyzing the results of lymphangiography, attention must be paid to the number, course, contour, diameter and valve status of the lymphatic vessels. The common X-ray signs of lymphatic vessel obstruction are summarized as follows. Lymphatic obstruction Lymphatic enlargement The lymphatic vessels were shown to be widened and twisted. Lymphatic obstruction Lymphatic congestion Iodized oil may remain in the lymphatic vessels for 24 hours or longer after injection. Lymphatic obstruction Lymphatic extravasation Due to the increased pressure in the lymphatic vessels, the lymphatic vessels rupture. When lymph enters the interstitial space, extravasation of contrast agent can be seen during angiography. Lymph fluid extravasates into the sheaths around blood vessels and nerves, and the contrast agent can depict the outline of the blood vessels. Lymph fluid breaks into the abdominal cavity, intestinal tract, urinary tract, and thoracic cavity, which can show signs of contrast agent entering the abdominal cavity, intestinal tract, urinary tract, and thoracic cavity, respectively. Lymphatic obstruction is reduced or eliminated It is common in limb lymphedema, which is manifested by a decrease in the number of lymphatic vessels, often accompanied by enlargement, distortion and extravasation of the lymphatic vessels. Lymphatic obstruction Lymphatic reflux It manifests as reverse filling of lymphatic vessels. If retrograde filling of lymphatic vessels around pelvic organs is found, it indicates obstruction of the common iliac lymph nodes or lumbar lymph trunk on that side. Lymphatic obstruction Lymphatic side The emergence of lymphatic collateral pathways is one of the most common signs of lymphatic obstruction and is also the main way the body uses to overcome obstruction. There are two basic forms of lymphatic lateral communication pathways. ① Lymphatic and venous anastomosis: In the area of lymphatic obstruction, contrast agent can be seen in the vein. This proves the existence of lymphovenous anastomosis. Lymphatic angiography often does not allow direct visualization of the pathways. ②Lymphatic and lymphatic anastomosis: It is the most common collateral pathway, similar to the collateral circulation produced after vascular occlusion. For example, when the lumbar lymph nodes are completely blocked, the contrast agent is shunted to the opposite side through the communicating lymphatic vessels at the aortic bifurcation, showing the contralateral lumbar lymph trunk. If the obstruction is located in the groin or subiliac region, extensive subcutaneous collateral lymphatic pathways can be shown in the thigh perineum, external genitalia, and anterior abdominal wall. |
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