Wen Zhe, Tong Guansheng, Liu Yong, Meeks Jacqui K, Ma Daqing, Yang Jigang
Departments of aNuclear Medicine bRadiology, Beijing Friendship Hospital cDepartment of Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China dRadiology of Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Nucl Med Commun. 2014 May;35(5):493-500. doi: 10.1097/MNM.0000000000000080.
The aim of this study was to analyze the imaging characteristics of (99m)Tc-dextran ((99m)Tc-DX) lymphatic imaging in the diagnosis of primary intestinal lymphangiectasia (PIL).
Forty-one PIL patients were diagnosed as having PIL with the diagnosis being subsequently confirmed by laparotomy, endoscopy, biopsy, or capsule colonoscopy. Nineteen patients were male and 22 were female. A whole-body (99m)Tc-DX scan was performed at 10 min, 1 h, 3 h, and 6 h intervals after injection. The 10 min and 1 h postinjection intervals were considered the early phase, the 3 h postinjection interval was considered the middle phase, and the 6 h postinjection interval was considered the delayed phase.
The imaging characteristics of (99m)Tc-DX lymphatic imaging in PIL were of five different types: (i) presence of dynamic radioactivity in the intestine, associated with radioactivity moving from the small intestine to the ascending and transverse colon; (ii) presence of delayed dynamic radioactivity in the intestine, no radioactivity or little radioactivity distributing in the intestine in the early phase, or significant radioactivity distributing in the intestine in the delayed phase; (iii) radioactivity distributing in the intestine and abdominal cavity; (iv) radioactivity distributing only in the abdominal cavity with no radioactivity in the intestines; and (v) no radioactivity distributing in the intestine and abdominal activity.
(99m)Tc-DX lymphatic imaging in PIL showed different imaging characteristics. Caution should be exercised in the diagnosis of PIL using lymphoscintigraphy. Lymphoscintigraphy is a safe and accurate examination method and is a significant diagnostic tool in the diagnosis of PIL.
本研究旨在分析（99m）锝-右旋糖酐（（99m）Tc-DX）淋巴显像在原发性肠淋巴管扩张症（PIL）诊断中的影像特征。
41例PIL患者经剖腹探查、内镜检查、活检或胶囊结肠镜检查确诊为PIL。其中男性19例，女性22例。注射后分别于10分钟、1小时、3小时和6小时进行全身（99m）Tc-DX扫描。注射后10分钟和1小时的扫描间隔被视为早期，注射后3小时的扫描间隔被视为中期，注射后6小时的扫描间隔被视为延迟期。
PIL患者（99m）Tc-DX淋巴显像的影像特征有五种不同类型：（i）肠道内存在动态放射性，伴有放射性从小肠向升结肠和横结肠移动；（ii）肠道内存在延迟动态放射性，早期肠道内无放射性或放射性极少，延迟期肠道内有明显放射性；（iii）放射性分布于肠道和腹腔；（iv）放射性仅分布于腹腔，肠道内无放射性；（v）肠道和腹腔内均无放射性分布。
PIL患者的（99m）Tc-DX淋巴显像表现出不同的影像特征。在使用淋巴闪烁显像诊断PIL时应谨慎。淋巴闪烁显像是一种安全准确的检查方法，是诊断PIL的重要诊断工具。
