Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, China.
Br J Surg. 2010 Mar;97(3):359-65. doi: 10.1002/bjs.6893.
Lymphoscintigraphy is widely used to image the lymphatic system. The aim of this study was to compare lymphoscintigraphy and dynamic magnetic resonance lymphangiography (MRL) in the investigation of extremity lymphoedema.
Sixteen patients with primary extremity lymphoedema and two with Klippel-Trenaunay syndrome with lymphoedema were examined by lymphoscintigraphy using the tracer (99)Tc-labelled dextran, and by MRL using gadobenate dimeglumine as contrast agent. Morphological abnormalities and functional state of the lymphatic systems of affected limbs were compared between the two imaging methods.
Lymphatic vessels were imaged in 14 of 18 limbs with lymphoedema using MRL, compared with one of 18 using lymphoscintigraphy. MRL detected the inguinal nodes in 16 of 17 patients, whereas lymphoscintigraphy revealed inguinal nodes in only nine. MRL revealed more precise information about structural and functional abnormalities of lymph vessels and nodes than lymphoscintigraphy by real-time measurement of lymph flow in vessels and nodes.
Dynamic MRL was more sensitive and accurate than lymphoscintigraphy in the detection of anatomical and functional abnormalities in the lymphatic system in patients with extremity lymphoedema.
淋巴闪烁显像术被广泛用于淋巴系统成像。本研究旨在比较淋巴闪烁显像术和动态磁共振淋巴造影术（MRL）在四肢淋巴水肿中的应用。
对 16 例原发性四肢淋巴水肿患者和 2 例 Klippel-Trenaunay 综合征伴淋巴水肿患者进行淋巴闪烁显像术（使用示踪剂（99）Tc 标记的右旋糖酐）和 MRL（使用钆贝葡胺作为造影剂）检查。比较两种成像方法对受累肢体淋巴系统的形态异常和功能状态。
MRL 成像显示 18 条肢体中有 14 条存在淋巴水肿，而淋巴闪烁显像术仅显示 1 条。MRL 检测到 17 例患者中的 16 个腹股沟淋巴结，而淋巴闪烁显像术仅显示 9 个。MRL 通过实时测量血管和淋巴结中的淋巴流量，提供了比淋巴闪烁显像术更精确的关于淋巴管和淋巴结结构和功能异常的信息。
在检测四肢淋巴水肿患者的淋巴系统解剖和功能异常方面，动态 MRL 比淋巴闪烁显像术更敏感、更准确。
