Rijke A M, Croft B Y, Johnson R A, de Jongste A B, Camps J A
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
J Nucl Med. 1990 Jun;31(6):990-8.
Lymphoscintigraphy, using technetium-99m-labeled sulphur microcolloid, was employed to study the flow and transport of lymph in the lower extremities of 39 consecutive patients in whom lymphedema of one or both legs was suspected clinically. Time-activity curves of four segments of each leg were evaluated for lymph capacity, flow and soft-tissue uptake, and compared with the results from film scintigraphy. Curve analysis provided quantitative evaluation of the extent of hypoplasia or aplasia in primary lymphedema and of lymphatic obstruction in secondary lymphedema, and is particularly suited to assess the involvement of lymphatics in chronic venous disease. Film scintigraphy, on the other hand, is preferable in cases in which the pattern of activity distribution in the affected extremity is diagnostic, such as in dermal back flow, traumatic lymphocele, or megalymphatics. Venography is most informative in cases of suspected underlying venous disease, but the role of lymphangiography, which shows only part of the lymphatic system and requires incision of the edematous tissues, is considered questionable.
采用锝-99m标记的硫微胶体进行淋巴闪烁造影，对39例临床怀疑有单侧或双侧下肢淋巴水肿的连续患者的下肢淋巴流动和转运情况进行研究。评估每条腿四个节段的时间-活性曲线，以测定淋巴容量、流量和软组织摄取情况，并与胶片闪烁造影的结果进行比较。曲线分析可对原发性淋巴水肿中发育不全或发育不全的程度以及继发性淋巴水肿中的淋巴管阻塞程度进行定量评估，特别适用于评估慢性静脉疾病中淋巴管的受累情况。另一方面，在受影响肢体的活性分布模式具有诊断意义的情况下，如真皮逆流、创伤性淋巴管瘤或巨淋巴管症，胶片闪烁造影更可取。静脉造影在怀疑有潜在静脉疾病的情况下提供的信息最多，但淋巴管造影仅显示部分淋巴系统且需要切开水肿组织，其作用被认为存在疑问。
