Department of Radiology, University Hospital of Freiburg, Freiburg, Germany.
Urol Oncol. 2011 Sep-Oct;29(5):515-22. doi: 10.1016/j.urolonc.2009.09.003. Epub 2009 Nov 13.
To assess, for the first time, the morphology of the lymphatic system in patients with diffuse lymphangiomatosis and genital involvement by magnetic resonance lymphangiography (MRL).
Ten patients with diffuse lymphangiomatosis and genital involvement were examined by MRL. Three locations were examined: first, the lower leg and foot region; second, the upper leg and the knee region; and third, the pelvic with retroperitoneal region. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MRL, a T1-weighted 3D-spoiled gradient-echo and a T2-weighted 3D-TSE sequence were used.
The size of the genital lymphangiomas, which were revealed in all patients, varied between 6 and 85 mm. In 60% of the patients, lymphangiomas were additionally detected at the level of the lower legs, and in 70% patients at the level of the upper leg. Furthermore, lymphangiomas were seen in the inguinal and retroperitoneal regions in 80%, and in the pelvic region and anterior abdominal wall in 90% of the patients examined. The genital lymphangiomas feeding lymphatic vessels were detected in 80% of the patients in the anterior abdominal wall and in 90% of the patients in the inguinal and pelvic regions; 90% of the patients suffered consecutively from a lymphedema of the lower extremities. All patients suffered from recurrent infections in the genital region; 80% of the patients repeatedly experienced genital lymphorrhea due to lympho-cutaneous fistulas and lymphcysts.
MRL is a safe and accurate minimal-invasive imaging modality for the evaluation of the lymphatic circulation in patients with diffuse lymphangiomatosis and genital involvement. Because the site and extent of the lymphangiomas with their feeding lymphatic vessels are important prognostic factors, performing radiologic evaluation with a high resolution is crucial for the therapeutic planning of patients.
首次通过磁共振淋巴造影术（MRL）评估弥漫性淋巴管瘤病和生殖器受累患者的淋巴系统形态。
对 10 例弥漫性淋巴管瘤病和生殖器受累患者进行 MRL 检查。检查了三个部位：第一，小腿和足部区域；第二，大腿和膝关节区域；第三，盆腔和腹膜后区域。MR 成像使用配备高性能梯度的 1.5T 系统进行。MRL 使用 T1 加权 3D 扰相梯度回波和 T2 加权 3D-TSE 序列进行。
所有患者均显示生殖器淋巴管瘤的大小在 6 至 85 毫米之间不等。在 60%的患者中，在小腿水平还发现了淋巴管瘤，在 70%的患者中在大腿水平发现了淋巴管瘤。此外，在 80%的患者中可以看到腹股沟和腹膜后区域的淋巴管瘤，在 90%的患者中可以看到骨盆区域和前腹壁的淋巴管瘤。在 80%的患者中，在腹股沟和盆腔区域的 90%的患者中可以检测到生殖器淋巴管瘤的供血淋巴管；90%的患者相继患有下肢淋巴水肿。所有患者的生殖器区域均有复发性感染；80%的患者因淋巴皮瘘和淋巴囊肿而反复出现生殖器淋巴液漏。
MRL 是评估弥漫性淋巴管瘤病和生殖器受累患者淋巴循环的一种安全、准确的微创成像方式。由于淋巴管瘤及其供血淋巴管的位置和范围是重要的预后因素，因此进行高分辨率的放射学评估对于患者的治疗计划至关重要。
