Lymphangiography

Lymphangiography is an imaging procedure that captures pictures of the body’s lymph nodes and lymph vessels and detects leaks.

It involves injecting a contrast dye into the lymph nodes so doctors can see the lymphatic channels using X-ray or MRI. It is a minimally invasive procedure that does not require incisions or leave scars.

There are two types:

• Intranodal lymphangiography: Uses X-ray technology and provides real-time images and data about the flow through lymphatic channels
• Magnetic resonance lymphangiography (MRL): Uses MRI technology to take snapshots of the lymphatic system and flow.

At Boston Children’s Hospital, we use intranodal lymphangiography as our standard because it provides more dynamic and detailed images. If we detect a leak during the procedure, we can perform an X-ray guided intervention at the same time to repair it, such as embolization.

We offer lymphangiography for patients we see in our Vascular Anomalies Center. Our team has more experience with intranodal lymphangiography than other interventional radiologists because we invented it. Before our team developed this technique, it was extremely difficult to examine the lymphatic channels and their function.

Lymphangiography is performed by our Interventional Radiology team, which treats patients with vascular anomalies from around the world. They perform more than 6,000 minimally invasive, image-guided procedures each year to diagnose and treat diseases in children.

We are working on modifications to make this procedure possible for children with cardiac defects and congenital heart disease, who cannot safely use the contrast dye due to risk of stroke.

In order to be eligible for this procedure, your child must have lymph nodes our team can access in the groin area. We have no age restrictions for lymphangiography. We have performed it on infants as young as a few days old.

We perform lymphangiography as an outpatient procedure or day surgery. The difference is whether or not your child requires general anesthesia, which we may recommend to keep your child still. It is not necessary for pain management.

If we recommend general anesthesia, you may need an appointment in our pre-op clinic. During this visit, you and your child will:

• Review important details and questions with a pre-op nurse
• Meet with an anesthesiologist, who will explain how your child is put to sleep for the procedure and review the consent process
• Undergo any necessary laboratory testing, such as blood work

If your child is undergoing lymphangiography, here’s what to expect:

• Your child will change into a hospital gown.
• Our team will bring you and your child to the room where the procedure takes place.
• The anesthesiologist will deliver medicine, called anesthesia, through an IV to help your child relax. (Young children may receive the medicine through a mask.) You may be able to stay in the room until your child is asleep.
• During the procedure, you will wait in a special area until we move your child to the post-anesthesia care unit (PACU).

Lymphangiography does not require an overnight hospital stay.

There are no major complications with lymphangiography. The only recovery involved relates to the anesthesia wearing off, which may include grogginess and, in some patients, slight nausea. Your child may experience soreness in the incision site for a few days.