Lymphangiography of the leg is performed by
Direct-contrast lymphangiography provides the finest details of the lymphatic anatomy. However, it is an invasive study that involves exposure and cannulation of lymphatics at the dorsum of the forefoot, followed by slow injection of contrast medium (ethiodized oil). The procedure is tedious, the cannulation often necessitates aid of magnification optics (frequently an operating microscope is needed), and the dissection requires some form of anesthetic. After cannulation of a superficial lymph vessel, contrast material is slowly injected into the lymphatic system.