Tokyo, Japan From the Department of Plastic and Reconstructive Surgery, University of Tokyo Hospital.
Plast Reconstr Surg. 2013 Dec;132(6):1612-1618. doi: 10.1097/PRS.0b013e3182a97edc.
The authors investigated the relationship between findings from indocyanine green lymphography and the condition of lymphatics according to the Normal, Ectasis, Contraction, Sclerosis Type classifications observed in each area during surgery.
The authors examined 43 limbs of 25 patients who had undergone lymphaticovenous anastomosis from April to July of 2012 at the Department of Plastic and Reconstructive Surgery, University of Tokyo Hospital. After the injection of indocyanine green, linear, splash, stardust, and diffuse patterns were determined. Visual findings of the collecting lymph vessels during the anastomosis at each incision site were evaluated using the Normal, Ectasis, Contraction, Sclerosis Type classifications.
Lymphaticovenous anastomosis was conducted on 164 collecting lymph vessels within 43 limbs of 25 people. Normal-type lymph vessels were observed in 36, ectasis type in 43, contraction type in 52, and sclerosis type in 33. Many normal vessels were found in the linear region, but the proportion of this type declined in the more severe stardust and diffuse regions. In contrast, no sclerosis-type vessels were found in the linear region, while the proportion of this type increased with lymphedema severity.
Indocyanine green lymphography findings and the Normal, Ectasis, Contraction, Sclerosis Type classification of collecting lymph vessels seem to have a relationship. An increase in the severity of lymphedema according to the indocyanine green lymphography findings indicated an increase in the stage of lymphedema according to the Normal, Ectasis, Contraction, Sclerosis Type classification.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.
作者根据手术中每个区域观察到的正常、扩张、收缩、硬化型分类，研究了吲哚菁绿淋巴造影与淋巴管状况之间的关系。
作者检查了 2012 年 4 月至 7 月在东京大学医院整形与重建外科接受淋巴静脉吻合术的 25 名患者的 43 条肢体。吲哚菁绿注射后，确定了线性、飞溅、星状和弥漫型。在每个切口部位进行吻合术时，使用正常、扩张、收缩、硬化型分类评估收集淋巴管的视觉发现。
对 25 名患者的 43 条肢体的 164 条收集淋巴管进行了淋巴静脉吻合术。36 个为正常型淋巴管，43 个为扩张型淋巴管，52 个为收缩型淋巴管，33 个为硬化型淋巴管。线性区域有许多正常血管，但在更严重的星状和弥漫区域，这种类型的比例下降。相反，在线性区域没有发现硬化型血管，而随着淋巴水肿的严重程度增加，这种类型的比例增加。
吲哚菁绿淋巴造影结果与收集淋巴管的正常、扩张、收缩、硬化型分类似乎存在关系。根据吲哚菁绿淋巴造影结果，淋巴水肿严重程度的增加表明根据正常、扩张、收缩、硬化型分类，淋巴水肿的阶段增加。
临床问题/证据水平：诊断，IV。
