title: Ultrasound-guided intranodal lymphangiography followed by thoracic duct embolization for treatment of postoperative bilateral chylothorax.
abstract: BACKGROUND
  Percutaneous thoracic duct embolization (TDE) is a safe, effective, and minimally invasive option for treating chylothorax. A recent report demonstrated the feasibility of ultrasound-guided intranodal lymphangiography as an alternative to pedal lymphangiography for visualization of the thoracic duct, promising relative technical ease and decreased procedure time for TDE.
  
  
  METHODS
  We report a case of postoperative bilateral chylothorax treated with ultrasound-guided intranodal lymphangiography followed by TDE.
  
  
  RESULTS
  Intranodal lymphangiography resulted in rapid opacification of the abdominal lymphatics, permitting technically successful primary and secondary embolization procedures. Deployment of metallic coils and liquid embolic agents within the thoracic duct produced rapid clinical and radiographic improvement.
  
  
  CONCLUSIONS
  Intranodal lymphangiography is a reliable, reproducible, and less technically challenging alternative to pedal lymphangiography.
authors.affiliation: Department of Radiology, Interventional Radiology Section, College of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Parvinian
authors.forename: Girish C
authors.initials: GC
authors.lastname: Mohan
authors.forename: Ron C
authors.initials: RC
authors.lastname: Gaba
authors.forename: David F
authors.initials: DF
authors.lastname: Saldanha
authors.forename: M Grace
authors.initials: MG
authors.lastname: Knuttinen
authors.forename: James T
authors.initials: JT
authors.lastname: Bui
authors.forename: Jeet
authors.initials: J
authors.lastname: Minocha
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002916:Chylothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D010996:Pleural Effusion / Q000209:etiology; D001261:Pulmonary Atelectasis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D015203:Reproducibility of Results; D012307:Risk Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: chylothorax; embolization; intranodal; lymphangiography; thoracic duct embolization