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Imaging:
Imaging,
typically MRI and/or MRA, is mainly used
to evaluate the extent and patency of the
deep veins.
MRI findings are variable because
of the wide range in the severity of this
disorder. The lymphatic component of the
disease may be macrocystic or microcystic
(see the MRI in coronal section).
Increased fat is often identified in the
areas of soft-tissue overgrowth. In severe cases, the deep venous system is
anomalous (hypoplastic or interrupted),
and drainage occurs mainly via markedly
dilated, anomalous superficial veins. The
pathognomonic marginal vein of Servelle is
frequently identified in the lateral calf
and thigh. MR
venography (MRV) is the imaging modality
of choice in the evaluation of the patency
of deep veins before attempts at surgery.
Contrast-enhanced angiography may reveal
discrete microarteriovenous fistulas.
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First
image is a conventional venogram showing a marginal
vein on the lateral side of the thigh with a large
communicating venous channel draining into the deep
veins. 2nd image is a MR venogram (MRV) demonstrating
multiple veins draining the leg via a marginal vein
with no visualization of the deep veins. Normal deep
veins in the right thigh. |
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