Duewell S, Hagspiel K D, Zuber J, von Schulthess G K, Bollinger A, Fuchs W A
Department of Medical Radiology, University Hospital Zurich, Switzerland.
Radiology. 1992 Jul;184(1):227-31. doi: 10.1148/radiology.184.1.1609085.
The authors assessed the use of magnetic resonance imaging in differentiating lymphedema, phlebedema, and lipedema of the lower limb. They examined 14 patients: five with lipedema, five with lymphedema, and four with phlebedema. T1- and T2-weighted transaxial sequences were performed before administration of gadolinium tetraazacyclododecane-tetraacetic acid (DOTA) and T1-weighted spin-echo sequences were performed after administration of Gd-DOTA in each patient. Images of patients with lipedema showed homogeneously enlarged subcutaneous layers, with no increase in signal intensity at T2-weighted imaging or after Gd-DOTA administration. Patients with phlebedema had areas containing increased amounts of fluid within muscle and subcutaneous fat. In lymphedema, a honeycomb pattern above the fascia between muscle and subcutis was observed, with a marked increase in signal intensity at T2-weighted imaging. After Gd-DOTA administration, there was only a slight increase in signal intensity in the subcutis in lymphedema and phlebedema and a moderate increase in signal intensity in muscle in phlebedema.
作者评估了磁共振成像在鉴别下肢淋巴水肿、静脉性水肿和脂肪性水肿中的应用。他们检查了14例患者：5例脂肪性水肿患者、5例淋巴水肿患者和4例静脉性水肿患者。在给钆四氮杂环十二烷四乙酸（DOTA）之前进行T1加权和T2加权横轴位序列检查，并在每位患者注射钆喷酸葡胺（Gd-DOTA）后进行T1加权自旋回波序列检查。脂肪性水肿患者的图像显示皮下层均匀增厚，在T2加权成像或注射Gd-DOTA后信号强度无增加。静脉性水肿患者在肌肉和皮下脂肪内有液体含量增加的区域。在淋巴水肿中，观察到肌肉和皮下组织之间筋膜上方呈蜂窝状，在T2加权成像时信号强度显著增加。注射Gd-DOTA后，淋巴水肿和静脉性水肿患者皮下组织信号强度仅有轻微增加，静脉性水肿患者肌肉信号强度有中度增加。
