Rezende Laura Ferreira de, Pedras Felipe Vilela, Ramos Celso Dario, Gurgel Maria Salete Costa
Departamento de Ginecologia, Obstetrícia e Mastologia, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2011 Sep-Oct;57(5):540-4. doi: 10.1590/s0104-42302011000500012.
To describe the preoperative upper limb lymphoscintigraphic pattern in women with breast cancer.
Thirty-seven patients undergoing lymphoscintigraphy within 30 days of surgery were investigated. Lymphoscintigraphic studies of 37 upper limbs ipsilateral to surgery and 32 contralateral upper limbs were performed. The examination protocol consisted in obtaining static images of the upper limb in semi-flexion after 10 minutes, and 1 and 2 hours after subcutaneous injection of 1 mCi (37 MBq) of Tc-99m-dextran in the dorsum of the hand. The velocity of axillary lymph node visualization (I, visible at 10 minutes; II, 1 hour; III, 2 hours; and IV, invisible) and degree (intensity) of nodal uptake (a, marked; b, moderate; c,mild; and d, absent) were analyzed.
Optimal lymphatic functional pattern (Ia) was observed in four (11%) patients, in the ipsilateral upper limb, and six (19%), in the contralateral upper limb. Worse condition was observed in three (8%) patients (IVd) in the ipsilateral upper limb and two (6%) patients in the contralateral upper limb. The remaining patients showed intermediate states of velocity and uptake intensity.
This study found relevant changes in preoperative lymphoscintigraphy, demonstrating preexisting functional differences in the lymphatic system.
描述乳腺癌女性患者术前上肢淋巴闪烁造影模式。
对37例在手术30天内接受淋巴闪烁造影的患者进行研究。对37条手术同侧上肢和32条对侧上肢进行淋巴闪烁造影研究。检查方案包括在手部背侧皮下注射1毫居里（37兆贝可）的锝-99m-葡聚糖后10分钟、1小时和2小时，获取上肢半屈曲位的静态图像。分析腋窝淋巴结显影速度（I，10分钟可见；II，1小时可见；III，2小时可见；IV，不可见）和淋巴结摄取程度（强度）（a，明显；b，中等；c，轻度；d，无）。
在同侧上肢，4例（11%）患者观察到最佳淋巴功能模式（Ia），在对侧上肢，6例（19%）患者观察到最佳淋巴功能模式。在同侧上肢，3例（8%）患者（IVd）和对侧上肢2例（6%）患者观察到较差情况。其余患者显示出显影速度和摄取强度的中间状态。
本研究发现术前淋巴闪烁造影有相关变化，表明淋巴系统存在预先存在的功能差异。
