Kataoka M, Kawamura M, Hamada K, Itoh H, Nishiyama Y, Hamamoto K
Department of Radiology, Ehime University, School of Medicine, Japan.
Br J Radiol. 1991 Dec;64(768):1119-21. doi: 10.1259/0007-1285-64-768-1119.
To evaluate the clinical usefulness of lymphoscintigraphy using 99Tcm human serum albumin (99Tc-HSA) in assessing lymphoedema in the lower extremities, lymphoscintigraphy was performed by subcutaneous injection of 7.4 MBq of 99Tcm-HSA in 26 patients with uterine cancer, previously treated by operation (OP) and/or radiation therapy (RT), and in five controls. Radioactivity at the injection site in the lower extremities was counted for 3 min at 10 min (A) and at 3 h (B) after injection, and clearance of 99Tcm-HSA was defined as (1-(B)/(A)) x 100(%). Clearance in controls was 46.8 +/- 3.9%, which was significantly more than those in the other treatment groups. Clearances in patients treated with both OP and RT were less than those in patients treated with either OP or RT alone (30.1 +/- 11.4 vs. 41.9 +/- 8.9, 43.7 +/- 9.6%, respectively; p less than 0.01). The clearance in legs with lymphoedema was less than those without lymphoedema in patients treated with both OP and RT (16.6 +/- 7.7 vs. 34.9 +/- 9.3%; p less than 0.01) and in patients treated with RT (33.1 +/- 7.4 vs. 48.0 +/- 5.6%; p less than 0.01). There was a significant difference between clearance in controls and clearance in non-oedematous patients' legs treated with OP and RT (p less than 0.01). In patients treated with RT alone, radiation dose was closely correlated with 99Tcm-HSA clearance and with the development of lymphoedema. These data suggest that lymphoscintigraphy using 99Tcm-HSA is useful in evaluating lymphoedema and that radiation dose is one of the factors in the development of lymphoedema.
为评估使用99锝人血清白蛋白（99Tc-HSA）的淋巴闪烁显像术在评估下肢淋巴水肿方面的临床实用性，对26例曾接受手术（OP）和/或放射治疗（RT）的子宫癌患者及5名对照者进行了淋巴闪烁显像术，通过皮下注射7.4MBq的99Tc-HSA进行。在注射后10分钟（A）和3小时（B）对下肢注射部位的放射性计数3分钟，99Tc-HSA的清除率定义为（1 - （B）/（A））×100（%）。对照者的清除率为46.8±3.9%，显著高于其他治疗组。接受OP和RT联合治疗的患者的清除率低于仅接受OP或RT治疗的患者（分别为30.1±11.4对41.9±8.9、43.7±9.6%；p＜0.01）。在接受OP和RT联合治疗的患者中，有淋巴水肿的腿部的清除率低于无淋巴水肿的腿部（16.6±7.7对34.9±9.3%；p＜0.01），在接受RT治疗的患者中也是如此（33.1±7.4对48.0±5.6%；p＜0.01）。对照者的清除率与接受OP和RT治疗的非水肿患者腿部的清除率之间存在显著差异（p＜0.01）。在仅接受RT治疗的患者中，放射剂量与99Tc-HSA清除率及淋巴水肿的发生密切相关。这些数据表明，使用99Tc-HSA的淋巴闪烁显像术在评估淋巴水肿方面是有用的，且放射剂量是淋巴水肿发生的因素之一。
