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  Indian J Med Microbiol
 

Figure 3: (Case II) (a) Preoperative LS upper limb images showing no discrete lymphatic channels in the right upper limb and no right axillary nodes. (b) Postop static image of right forearm showing count statics improvement at flap site. (c) MR lymphangiogram (coronal MIP) at 5 min and 30 min post contrast. Intracutaneous contrast administration showing enhancement of the subdermal lymphatic channels and veins (bold arrow). On dynamic MRL, the beaded and irregular lymphatic enhancement increases and progresses proximally with time (arrows) while venous enhancement (arrowheads) decreases. (d) Vascularized lymph node transfer site, (e) Noncontrast CT and fused SPECTCT images demonstrating colloid accumulation along new lymphatic channels at graft site (note: fat and surgical clips)

Figure 3: (Case II) (a) Preoperative LS upper limb images showing no discrete lymphatic channels in the right upper limb and no right axillary nodes. (b) Postop static image of right forearm showing count statics improvement at flap site. (c) MR lymphangiogram (coronal MIP) at 5 min and 30 min post contrast. Intracutaneous contrast administration showing enhancement of the subdermal lymphatic channels and veins (bold arrow). On dynamic MRL, the beaded and irregular lymphatic enhancement increases and progresses proximally with time (arrows) while venous enhancement (arrowheads) decreases. (d) Vascularized lymph node transfer site, (e) Noncontrast CT and fused SPECTCT images demonstrating colloid accumulation along new lymphatic channels at graft site (note: fat and surgical clips)