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Page 12 of 14 Calderwood et al. Plast Aesthet Res 2021;8:40 https://dx.doi.org/10.20517/2347-9264.2021.14

cooperation is necessary to obtain good quality and useful scans.

No studies were found to report a cost analysis of MRL compared to other imaging modalities for
lymphoedema. It would be a future area of interest for determining the practicalities of using MRL and the
cost versus benefit of MRL compared to lymphoscintigraphy and indocyanine green lymphography.

CONCLUSION
MRL is recognised as an accurate and safe imaging modality to visualize the lymphatic pathways. MRL can
detect secondary changes in the skin and subcutaneous tissue, accurately demonstrate the extent and
location of oedema, and provide a functional assessment of the lymphatic pathways. It is a valuable tool in
diagnosing, classifying, staging, and identifying the cause of both primary and secondary lymphoedema. In
addition, it has been reported useful for pre-operative planning and post-operative surveillance.

Both contrast and non-contrast MRL scans have their strengths and weaknesses, and obtaining a
combination of both heavily T2-weighted and post-contrast T1-weighted sequences is recommended by
many articles as the optimal method for assessing lymphoedema. As MRL becomes increasingly used, we
will likely learn the extent of its benefits and limitations and may potentially use it to enhance our
knowledge of lymphoedema further.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Calderwood A, Ho-Shon K, Suami H
Performed data acquisition, as well as provided editorial support: Thompson B

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
All figures were obtained copyright permission for use in this manuscript.

Copyright
© The Author(s) 2021.

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