Khan O, Maharaj P, Rampaul R, Archibald A, Naipaul R, Loutan N
Units of Radiology and Nuclear Medicine, University of the West Indies, St Augustine, Trinidad and Tobago, West Indies.
West Indian Med J. 2003 Jun;52(2):136-9.
Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), venography, lymphoscinti-graphy (LS) and contrast lymphography are frequently utilized in the evaluation of lower limb oedema but no clinical data from the Caribbean have been published on the role of LS despite its well-recognized clinical application. The successful clinical application of CT, colour doppler sonography and MRI in differentiating the various causes of lower limb oedema is well understood. Lymphoscintigraphy has found less acceptability especially in the Caribbean where nuclear imaging techniques are only now currently being developed. This paper describes the initial experience with this technique in 15 patients over a five-year period and discusses its value when lower limb lymphoedema is suspected. Scintigrams were analyzed for visualization of lymph vessels and lymph nodes, dilatation of lymphatic vessels, collaterals and dermal back flow. Lymphoscintigrams were classified as normal (n = 5) or consistent with lymphoedema (n = 10). Failure to visualize lymphatic vessels occurred in two cases of suspected primary lymphoedema. In the remaining eight cases of secondary lymphoedema, a positive study based on altered lymphatic flow and anatomy was recorded. An alternative explanation was offered in three out of five cases in which a normal lymphoscintigram was obtained.
超声、计算机断层扫描（CT）、磁共振成像（MRI）、静脉造影、淋巴闪烁造影（LS）和对比淋巴造影常用于评估下肢水肿，但尽管LS在临床应用中已得到广泛认可，但加勒比地区尚未发表关于其作用的临床数据。CT、彩色多普勒超声和MRI在鉴别下肢水肿的各种病因方面的成功临床应用已广为人知。淋巴闪烁造影的接受度较低，尤其是在加勒比地区，核成像技术目前才刚刚开始发展。本文描述了在五年期间对15例患者使用该技术的初步经验，并讨论了在怀疑下肢淋巴水肿时其价值。分析闪烁图以观察淋巴管和淋巴结的显影、淋巴管扩张、侧支循环和皮肤反流情况。淋巴闪烁图分为正常（n = 5）或与淋巴水肿一致（n = 10）。在两例疑似原发性淋巴水肿的病例中未观察到淋巴管显影。在其余八例继发性淋巴水肿病例中，记录到基于淋巴流和解剖结构改变的阳性研究结果。在五例获得正常淋巴闪烁图的病例中，有三例给出了另一种解释。
