Arrivé Lionel, Derhy Sarah, El Mouhadi Sanaâ, Monnier-Cholley Laurence, Menu Yves, Becker Corinne
Department of Radiology, AP-HP Groupe Hospitalier Saint-Antoine, Paris, France.
Department of Surgery, AP-HP Hôpital Européen Georges Pompidou, Paris, France.
J Reconstr Microsurg. 2016 Jan;32(1):80-6. doi: 10.1055/s-0035-1549133. Epub 2015 Mar 31.
Different imaging techniques have been used for the investigation of the lymphatic channels and lymph glands. Noncontrast magnetic resonance (MR) lymphography has significant advantages in comparison with other imaging modalities.
Noncontrast MR lymphography uses very heavily T2-weighted fast spin echo sequences which obtain a nearly complete signal loss in tissue background and specific display of lymphatic vessels with a long T2 relaxation time. The raw data can be processed with different algorithms such as maximum intensity projection algorithm to obtain an anatomic representation.
Standard T2-weighted MR images easily demonstrate the location of edema. It appears as subcutaneous infiltration of soft tissue with a classical honeycomb pattern. True collection around the muscular area may be demonstrated in case of severe lymphedema. Lymph nodes may be normal in size, number, and signal intensity; in other cases, lymph nodes may be smaller in size or number of lymph nodes may be restricted. MR lymphography allows a classification of lymphedema in aplasia (no collecting vessels demonstrated); hypoplasia (a small number of lymphatic vessels), and numerical hyperplasia or hyperplasia (with an increased number of lymphatic vessels of greater and abnormal diameter).
Noncontrast MR lymphography is a unique noninvasive imaging modality for the diagnosis of lymphedema. It can be used for positive diagnosis, differential diagnosis, and specific evaluation of lymphedema severity. It may also be used for follow-up evaluation after treatment.
不同的成像技术已被用于研究淋巴管和淋巴结。与其他成像方式相比，非增强磁共振（MR）淋巴造影具有显著优势。
非增强MR淋巴造影使用非常重的T2加权快速自旋回波序列，该序列在组织背景中获得几乎完全的信号丢失，并能特异性显示具有长T2弛豫时间的淋巴管。原始数据可以用不同的算法进行处理，如最大强度投影算法，以获得解剖学图像。
标准的T2加权MR图像很容易显示水肿的位置。它表现为具有典型蜂窝状模式的软组织皮下浸润。在严重淋巴水肿的情况下，可能会显示肌肉区域周围的真正积液。淋巴结的大小、数量和信号强度可能正常；在其他情况下，淋巴结可能较小或数量受限。MR淋巴造影可以对淋巴水肿进行分类，分为发育不全（未显示收集血管）、发育不良（少量淋巴管）以及数量性增生或增生（淋巴管数量增加且直径更大且异常）。
非增强MR淋巴造影是一种独特的用于诊断淋巴水肿的非侵入性成像方式。它可用于淋巴水肿的阳性诊断、鉴别诊断以及严重程度的特异性评估。它也可用于治疗后的随访评估。
