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A retrospective analysis of a prospectively collected lymphatic malformation data base was performed that included 16 patients (5 males, 11 females; mean age, 15 years; range, 1=47 years). Patients with at least 1 microcystic lymphatic malformation component demonstrated on MR imaging treated by lymphographic-like technique bleomycin infusion were included in the study. Patient interviews and MR imaging were performed to assess subjective and objective clinical improvement (microcystic lymphatic malformation size decrease of >30%). The authors observed no major and 3 minor complications: 1 eyelid infection, 1 case of severe postprocedural nausea and vomiting, and 1 case of skin discoloration. MR imaging objective improvement was observed in 5/16 (31%) patients; overall improvement of clinical symptoms was obtained in 93% of treated patients. Bleomycin lymphographic-like technique for microcystic lymphatic malformations was safe and feasible with objective improvement in about one-third of patients.

Twenty patients with deep lumbosacral spinal dural arteriovenous fistulas were included in this series. Cord T2 hyperintensity and contrast enhancement were present in most cases. The filum vein and/or lumbar veins were dilated in 95% of patients. Time-resolved contrast-enhanced dynamic MRA indicated a spinal DAVF at or below the L5 vertebral level in 7/8 (88%) patients who received time-resolved contrast-enhanced dynamic MRA before DSA. A bilateral arterial supply of the fistula was detected via DSA in 5 (25%) patients. The authors conclude that time-resolved contrast-enhanced dynamic MRA facilitates the detection of the drainage vein and helps to localize deep lumbosacral-located fistulas with a high sensitivity before DSA. Definite detection remains challenging and requires conventional spinal angiography.