Richards T B, McBiles M, Collins P S
Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, California 94129-6700.
Ann Vasc Surg. 1990 May;4(3):255-9. doi: 10.1007/BF02009453.
Lymphoscintigraphy has been very useful in determination of lymphatic abnormalities. However, the radioactive isotopes used have been investigational and difficult obtain. The purpose of this study was to examine patients with extremity edema by lymphoscintigraphy using a radioactive colloid readily available in our nuclear pharmacy, Technetium 99m sulfur minicolloid. Forty limbs in 20 patients were evaluated using Technetium 99m sulfur minicolloid lymphoscintigraphy. All patients had lower extremity edema initially attributed to a venous or lymphatic etiology. There were 12 patients with normal bilateral studies. Seven patients exhibited unilateral obstruction to lymphatic flow, and one had unilateral enhanced flow of lymph. Those with normal studies included five patients with nonspecific edema, four with varicosities, and one patient each with acute deep vein thrombosis, chylous ascites, and excision of the greater saphenous vein for arterial bypass grafting. Five patients with obstructed patterns had previous arterial bypass procedures, one had trauma to the extremity, and one had lymphedema tarda. The one enhanced lymphoscintigraphic pattern was seen in a patient with acute cellulitis. All patients had Doppler venous examinations and other studies included strain gauge phlethysmography, venograms, computed tomography, magnetic resonance imaging, and ultrasound. As with other scintigraphic imaging agents used to study lymphatic flow, Technetium 99m provides clinically useful information in evaluating the swollen extremity noninvasively.
淋巴闪烁造影术在确定淋巴异常方面非常有用。然而，所使用的放射性同位素一直处于研究阶段且难以获得。本研究的目的是使用我们核药房 readily available（此处原文有误，可能是“readily available”，意为“容易获得的”）的放射性胶体锝99m硫微胶体，通过淋巴闪烁造影术检查患有肢体水肿的患者。使用锝99m硫微胶体淋巴闪烁造影术对20例患者的40条肢体进行了评估。所有患者最初均有下肢水肿，病因归因于静脉或淋巴系统。有12例患者双侧检查结果正常。7例患者表现出单侧淋巴引流受阻，1例患者表现出单侧淋巴引流增强。检查结果正常的患者包括5例非特异性水肿患者、4例静脉曲张患者，以及各1例患有急性深静脉血栓形成、乳糜腹水和为动脉搭桥移植而切除大隐静脉的患者。5例有梗阻表现的患者曾接受过动脉搭桥手术，1例有肢体创伤，1例有迟发性淋巴水肿。在1例急性蜂窝织炎患者中观察到1例淋巴闪烁造影增强表现。所有患者均进行了多普勒静脉检查，其他检查包括应变计体积描记法、静脉造影、计算机断层扫描、磁共振成像和超声检查。与用于研究淋巴引流的其他闪烁造影剂一样，锝99m在无创评估肿胀肢体方面提供了临床有用的信息。
