Dynamic Contrast-Enhanced MR Lymphangiogram of the Central Lymphatic System in Children: Overcoming the challenges in a non-hybrid environment

Motivation: Performing dynamic contrast-enhanced MR lymphangiogram (DCMRL) in children require general anesthesia. In a non-hybrid environment, the nodal puncture for DCMRL is often performed in the angiography suite. Transporting a pediatric patient under general anesthesia with needles to an MRI environment presents unique challenges. Goal(s): Develop a safe and effective workflow for DCMRL in non-hybrid setting. Approach: Meticulous planning and collaborations between radiology and anesthesiology teams ensure safe execution of DCMRL. Using contrast-enhanced ultrasound (CEUS) also improve the logistic of intranodal DCMRL by minimizing patient transfer. Results: Careful coordination between Radiology and Anesthetic team results in successful and safe intranodal and intrahepatic DCMRL. . Impact: The ability to perform DCMRL in non-hybrid environment has significant implications for accurate diagnosis of lymphatic diseases, enabling improved treatment planning and better patient outcomes.