The radiographic demonstration of cervical lymph nodes following intrathyroid injection of Ultrafluid Lipiodol is reported in 20 dogs. The distribution was similar to that reported in 1927 by Caylor et al., who injected India ink under the thyroid capsule. A discrepancy between the radiographic demonstration and autopsy demonstration of nodes containing oil was noted. This suggested that the lymphatic dissemination from the thyroid was wider than was obvious by lymphography using this technique or that the iodine required for radiopacity was trapped by the thyroid. The deep jugular chain on the side of the injection was demonstrated by at least one opacified node in each of the 20 dogs. Contralateral opacification was noted in seven dogs. A lipogranulomatous reaction in the injected thyroid also was recorded. In only two glands was this reaction of major proportions. No untoward clinical effects were noted in the dogs.
HE PRESENT POPULARITY OF LYMPHOCRA-T phy stems from Kinmonth's introduction of a method of endolymphatic injection of radiopaque media into vessels of the lower extremity.10.11 Lower extremity injection results in opacification of inguinal, iliac and retroperitoneal nodes, thuracic duct and, occasionally, supraclavicular nodes. Because of the importance of lymphatics of the head and neck it followed that cervical lymphography should be attempted. Methods involving the direct injection of isolated postauricular lymphatics,ls 7-9 submental lymphatics,g tongue lymphatics13 and parotid lymph nodes1 have been described.
Direct endolymphatic injection in the cervical region has four disadvantages:
- T h e technique is difficult and cumbersome;