Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Med Sci Monit. 2010 Sep;16(9):BR313-9.
The aim of this study was to investigate the value and technical methods of 3D dynamic contrast-enhanced magnetic resonance lymphangiography (MRL) in the assessment of lymphatic anatomy and function in the presence of extremity lymphedema.
MATERIAL/METHODS: An improved experimental model of obstructive lymphedema was established in 1 hind limb of 6 New Zealand White rabbits. 3D contrast-enhanced MRL was performed with a 3.0-T MR unit after the intracutaneous injection of Gd-BOPTA into the interdigital webs of the dorsal paws. Maximum-intensity projection (MIP) was used to reconstruct the images of the lymphatic system. The dynamic nodal enhancement in the popliteal fossa and time-signal intensity curves between lymphedematous and contralateral limbs were compared. Morphologic abnormalities of the lymphatic system were also evaluated and compared with lymphoscintigraphy (LSG).
3D dynamic contrast-enhanced MRL images were obtained after the administration of Gd-BOPTA. In the normal limb, the popliteal fossa lymph nodes and their afferent and efferent lymph-collecting vessels were clearly visualized as the Gd tracer was rapidly cleared from the interstitial compartment. In contrast, the Gd tracer accumulated slowly at the prior surgical site in the lymphedematous limb. The nodal enhancement of lymphedematous limbs was significantly less than that of the contralateral limbs (P<0.01). Types of time-signal intensity curves were also significantly different between the 2 groups (P<0.001).
3D dynamic contrast-enhanced MRL can visualize the precise anatomy of lymphatic vessels and lymph nodes in extremity lymphedema, as well as objectively evaluate the functional status of lymph flow transport.
本研究旨在探讨 3D 动态对比增强磁共振淋巴造影术（MRL）在评估四肢淋巴水肿时评估淋巴管解剖和功能的价值和技术方法。
材料/方法：在 6 只新西兰白兔的 1 条后肢中建立改良的阻塞性淋巴水肿实验模型。在背足蹼的皮内注射 Gd-BOPTA 后，使用 3.0T MR 仪进行 3D 对比增强 MRL。最大强度投影（MIP）用于重建淋巴管系统的图像。比较了腘窝内节点增强和淋巴水肿与对侧肢体之间的时间信号强度曲线。还评估了淋巴系统的形态学异常，并与淋巴闪烁显像（LSG）进行了比较。
在给予 Gd-BOPTA 后获得了 3D 动态对比增强 MRL 图像。在正常肢体中，Gd 示踪剂迅速从间质间隙清除，腘窝淋巴结及其输入和输出淋巴管的显影清晰。相比之下，在淋巴水肿肢体的先前手术部位，Gd 示踪剂缓慢积聚。淋巴水肿肢体的节点增强明显低于对侧肢体（P<0.01）。两组之间的时间信号强度曲线类型也有显著差异（P<0.001）。
3D 动态对比增强 MRL 可以可视化四肢淋巴水肿中淋巴管和淋巴结的精确解剖结构，并客观评估淋巴流动运输的功能状态。
