Dual Agent Relaxation Contrast MR Lymphangiography (DARC-MRL) effectively eliminates venous enhancement through the up-front i.v. injection ferumoxytol (USPIO causing marked blood T2* shortening) combined with obtaining MRL datasets at prolonged, precisely determined echo times. Echo time prolongation does cause an approximately 45% loss of lymphatic signal intensity, however with excellent lymphatic-to-tissue contrast, there was no clinically significant lymphatic signal loss. Data regarding the time course of lymphatic enhancement progression demonstrate most MRL enhancement can be fully captured in only two time points, allowing for a more efficient, faster examination. Multi-echo DARC offers to add further robustness and visualization capability.
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