Lymphatic Imaging and Interventions in Children: Current Practice.

PURPOSE: To provide a decision-oriented overview of clinical manifestations, imaging strategies, and minimallyinvasive treatment of pediatric lymphatic flow disorders. MATERIALS AND METHODS: Current practice in fluoroscopic lymphangiography, dynamic contrast-enhanced magneticresonance lymphangiography, and image-guided interventions was reviewed, emphasizing congenital heart disease,complex lymphatic anomalies, procedural adaptations, and safety. RESULTS: Lymphatic flow disorders can cause chylous eff usions, plastic bronchitis, protein-losing enteropathy, andlymphedema. Modern imaging enables high-resolution assessment of anatomy and abnormal flow and guidesselective interventions. Small clinical series report favorable outcomes after selective embolization of abnormallymphatic channels; however, inappropriate or nonselective embolization may worsen lymphatic failure. CONCLUSIONS: Accurate clinical characterization, tailored imaging, and treatment in experienced multidisciplinarycenters are essential for safe, individualized management.