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. 2026 Aug 24;6:1910524. doi: 10.3389/fradi.2026.1910524

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© 2026 Chen, Tu, Huang, Zhang, Tang, Dai, Huang and Lin.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Panel A: X-ray image showing the lumbar spine with an arrow indicating a pathological area near the vertebrae. Panel B: X-ray with spinal hardware and a radiopaque area, arrowhead indicating a tubular object. Panel C: Fluoroscopic image displaying needle or catheter insertion into vertebral tissue, arrow marking the entry. Panel D: Axial CT scan of the abdomen highlighting a vertebral abnormality with an arrow, needle visible. Panel E: Axial CT scan demonstrating needle trajectory and a highlighted structure at the end, marked by an arrowhead. Panel F: Fluoroscopic image illustrating needle placement into vertebral tissue, arrow indicates target area. — Typical interventional treatment images of lymphatic leakage. (A) A patient presenting with chyluria. Lipiodol lymphangiography demonstrates retrograde filling of Lipiodol into the left renal lymphatic system (arrow), confirming abnormal lymphatic-urinary communication. (B) A patient with chylous ascites following radical hysterectomy. Lipiodol lymphangiography reveals Lipiodol extravasation from the presacral lymphatic plexus (triangle arrow) into the peritoneal cavity, with subsequent accumulation within an abdominal drainage catheter (asterisk). (C) A patient with chylous ascites post-Whipple procedure (pancreaticoduodenectomy). Lipiodol lymphangiography identifies active leakage at the left L3 lumbar lymphatic trunk (thin arrow), with Lipiodol pooling in the peritoneal cavity. (D) CT-guided embolization of lymphatic vessels draining into the left renal region for (A). A mixture of Lipiodol and temperature-sensitive gel (TempSLE) was injected to occlude the pathological lymphatic channels (arrow), achieving complete resolution of chyluria. (E) CT-guided direct puncture of the lymphatic leakage site adjacent to the drainage catheter. TempSLE was injected to achieve targeted embolization (triangle arrow) for (B), resulting in immediate cessation of chylous fluid output. (F) Fluoroscopy-guided direct puncture of the leaking lumbar lymphatic vessel. A combination of TempSLE and Lipiodol was administered to embolize the leakage site (thin arrow), effectively sealing the defect and resolving ascites for (C).