Karaçavuş Seyhan, Yılmaz Yunus Keser, Ekim Hasan
Bozok University Faculty of Medicine, Department of Nuclear Medicine, Yozgat, Turkey Phone: +90 505 267 82 09 E-mail:
Mol Imaging Radionucl Ther. 2015 Jun 5;24(2):80-4. doi: 10.4274/mirt.58077.
The purpose of this study was to investigate the clinical significance of lymphoscintigraphy imaging in the evaluation of lower extremity lymphedema.
Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 123 patients (M/F: 43/80, mean age 57.5±13.1 years, range 16-78 years) who had clinical evidence of lower extremity swelling with suspicion of lymphedema, and were referred for routine lymphoscintigraphy. Lymphoscintigraphy scan was started as dynamic viewing followed by static whole body imaging at 10 minute, 1 hour and 4 hours after injection.
Eighty-seven patients had lymphedema. Patients who had lymphedema were divided into two groups according to their scintigraphy findings: Group I included 58 patients without uptake in the popliteal nodes, and group II included 29 patients with positive popliteal nodes. The rate of popliteal node visualization was higher in patients with dermal backflow as compared to those without dermal backflow (p<0.001). The duration of lymphedema was also longer in patients with dermal backflow and popliteal nodes (p<0.004).
Lymphoscintigraphy is a reliable, easily applied and well-tolerated objective method to diagnose lower extremity lymphedema. Uptake by popliteal lymph nodes and the presence of dermal backflow on lymphoscintigraphy, which is performed for evaluation of the lower limb lymphedema, were important signs indicating longer disease duration and higher severity of lymphatic dysfunction.
本研究旨在探讨淋巴闪烁成像在评估下肢淋巴水肿中的临床意义。
对123例临床有下肢肿胀且怀疑为淋巴水肿的患者（男/女：43/80，平均年龄57.5±13.1岁，范围16 - 78岁）双足第一趾蹼间隙皮下注射99m锝标记的纳米胶体，并进行常规淋巴闪烁成像检查。注射后10分钟、1小时和4小时开始进行动态观察，随后进行静态全身成像。
87例患者存在淋巴水肿。根据闪烁成像结果，将淋巴水肿患者分为两组：I组包括58例腘窝淋巴结无摄取的患者，II组包括29例腘窝淋巴结阳性的患者。与无真皮回流的患者相比，有真皮回流的患者腘窝淋巴结显影率更高（p<0.001）。有真皮回流且腘窝淋巴结阳性的患者淋巴水肿持续时间也更长（p<0.004）。
淋巴闪烁成像术是诊断下肢淋巴水肿的一种可靠、易于应用且耐受性良好的客观方法。在评估下肢淋巴水肿时，腘窝淋巴结摄取及淋巴闪烁成像上真皮回流的存在是疾病持续时间较长和淋巴功能障碍严重程度较高的重要征象。
