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Figure 4. Sample lower extremity MR lymphangiography exam in a 67-year-old man with long-standing unilateral right lower extremity lymphedema. (A) Coronal T2-weighted single-shot fast-spin echo MRI shows unilateral right lower extremity lymphedema characterized by both excess fat and water accumulation. (B) Coronal heavily T2-weighted fast spin-echo MRI highlights the distribution of fluid accumulation with greater conspicuity. (C) Coronal T1-weighted Dixon water-only 3D spoiled gradient echo MRI obtained 30 min after lymphatic contrast injection shows dilated lymphatics channels in the medial right ankle and thigh (arrows). (D) Coronal T1-weighted Dixon water-only 3D spoiled gradient echo MRI venogram obtained 120 s after intravenous contrast administration shows normal venous outflow in the right lower extremity. MRI: Magnetic resonance imaging.