Department of Radiology, Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dong Fang Rd, Shanghai 200127, China.
Eur J Vasc Endovasc Surg. 2012 Jan;43(1):106-11. doi: 10.1016/j.ejvs.2011.09.007. Epub 2011 Oct 14.
To explore the feasibility of using 3T high-resolution MR lymphangiography to characterize inguinal lymphatic vessel leakage (LVL).
Sixteen patients with known inguinal LVL underwent 3T MR lymphangiography and T(2)-weighted imaging. The presence or absence of inguinal LVL and the responsible lymphatic vessels were determined using the above imaging modalities and confirmed by surgical procedure. Afterwards, fifteen patients with recurring LVL following conservative treatment were referred to surgical intervention.
Specific inguinal LVL enhancement patterns and leaking lymphatic vessels were detected in 15 of 16 patients. Compared to the SNR of enhanced lymph nodes, that of the enhanced LVL was significantly greater (t = 7.149, p < 0.01), thereby making it possible to differentiate between LVL sites and enhancing inguinal lymph nodes. Furthermore, the steepest contrast enhancement curve slope of enhanced LVL was lower than that of enhanced lymph nodes (t = -2.860, p = 0.02). After MR diagnosis, 15 patients successfully underwent open exploration and ligation of the leaking lymphatic vessel. Clinical follow-up did not demonstrate recurrence of lymphatic fluid in the groin.
High-resolution MR lymphangiography combined with T(2)-weighted imaging is a promising approach to identifying specific features of lymphatic vessel leakage in the groin.
探索使用 3T 高分辨率磁共振淋巴造影术来描述腹股沟淋巴液漏（LVL）的可行性。
16 例已知腹股沟 LVL 的患者接受了 3T MR 淋巴造影术和 T2 加权成像。使用上述成像方式确定腹股沟 LVL 的存在与否以及责任淋巴管，并通过手术程序确认。之后，15 例保守治疗后复发 LVL 的患者被转诊接受手术干预。
在 16 例患者中，有 15 例检测到特定的腹股沟 LVL 增强模式和渗漏淋巴管。与增强淋巴结的 SNR 相比，增强 LVL 的 SNR 显著更高（t=7.149，p<0.01），从而可以区分 LVL 部位和增强的腹股沟淋巴结。此外，增强 LVL 的陡峭度增强曲线斜率低于增强淋巴结（t=-2.860，p=0.02）。MR 诊断后，15 例患者成功接受了漏淋巴管的开放探查和结扎。临床随访未显示腹股沟处淋巴液再次出现。
高分辨率磁共振淋巴造影术结合 T2 加权成像，是一种很有前途的方法，可以识别腹股沟淋巴管漏的特定特征。
