Berman C G, Norman J, Cruse C W, Reintgen D S, Clark R A
Department of Radiology, H. Lee Moffitt Cancer Center, Tampa, FL.
Ann Plast Surg. 1992 Jan;28(1):29-32. doi: 10.1097/00000637-199201000-00010.
The development and rationale for the use of lymphoscintigraphy in the preoperative evaluation of patients with malignant melanoma being considered for elective lymph node dissection is reviewed. This overview is updated by an analysis of 135 patients with early stage malignant melanoma involving the head, neck, shoulders, and trunk at Moffitt Cancer Center and Research Institute at the University of South Florida (Tampa, FL). High discordancy rates (overall, 41%) were seen between drainage patterns predicted from historical anatomical guidelines and those revealed by the lymphoscintigraphic examination. The high discordancy rate was most pronounced in the head (64%) and the neck (73%). Surgical management was changed in 33% of the patients, overall. A preoperative lymphoscintigram is recommended for all patients with melanoma with head, neck, and truncal lesions evaluated for elective lymph node dissection as the lymphatic drainage patterns are often unpredictable and variable.
本文回顾了在考虑对恶性黑色素瘤患者进行择期淋巴结清扫术的术前评估中，使用淋巴闪烁造影术的发展情况及基本原理。通过对南佛罗里达大学莫菲特癌症中心和研究所（佛罗里达州坦帕市）135例头、颈、肩和躯干早期恶性黑色素瘤患者的分析，对这一综述进行了更新。根据历史解剖学指南预测的引流模式与淋巴闪烁造影检查显示的模式之间存在较高的不一致率（总体为41%）。这种高不一致率在头部（64%）和颈部（73%）最为明显。总体而言，33%的患者手术管理发生了改变。对于所有因择期淋巴结清扫术而接受评估的头、颈和躯干病变黑色素瘤患者，建议术前进行淋巴闪烁造影，因为淋巴引流模式往往不可预测且多变。
