Chowdhry Muhammed, Rozen Warren Matthew, Griffiths Matthew
1 St. Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Mid Essex Hospital Services NHS Trust, Chelmsford, Essex CM1 7ET, UK ; 2 Department of Surgery, School of Clinical Science at Monash Health, Faculty of Medicine, Monash University, Monash Medical Centre, Clayton 3168, Victoria, Australia ; 3 Department of Surgery, Monash University, Level 5, E Block, Monash Medical Centre, Clayton 3168, Victoria, Australia.
Gland Surg. 2016 Apr;5(2):187-96. doi: 10.3978/j.issn.2227-684X.2015.11.06.
Early detection and diagnosis of upper extremity lymphoedema in patients after mastectomy and axillary lymph node clearance is important in order to treat disease before it is too advanced to achieve favourable outcomes. Patients with disease refractory to conservative management can be efficiently assessed for diagnosis and surgical intervention using advanced lymphatic imaging techniques. The current paper highlights the more readily available of these: lymphoscintigraphy, indocyanine green (ICG) lymphangiography and immunofluorescence, magnetic resonance lymphangiography (MRL) and computed tomographic lymphangiography in combination or individually. With such techniques, both diagnosis and treatment of lymphoedema has become more readily achieved, with lymphatico-venous and lymphatico-lymphatic anastomosis, and lymph node transfer now increasingly common undertakings.
对于接受乳房切除术和腋窝淋巴结清扫术的患者，早期发现和诊断上肢淋巴水肿很重要，以便在病情发展到无法取得良好治疗效果之前进行治疗。对于保守治疗无效的患者，可使用先进的淋巴成像技术对其进行有效评估，以进行诊断和手术干预。本文重点介绍了其中更容易获得的技术：淋巴闪烁显像、吲哚菁绿（ICG）淋巴管造影和免疫荧光、磁共振淋巴管造影（MRL）以及计算机断层淋巴管造影，这些技术可单独或联合使用。有了这些技术，淋巴水肿的诊断和治疗变得更容易实现，淋巴管静脉吻合术、淋巴管淋巴管吻合术以及淋巴结转移现在越来越常见。
