Okayama, Japan; and Sydney, New South Wales, Australia.
From the Departments of Human Morphology and Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science; and the Faculty of Medicine and Health Sciences, Macquarie University.
Plast Reconstr Surg. 2018 May;141(5):1161-1164. doi: 10.1097/PRS.0000000000004315.
Identification of the lymphatic system in cadavers is painstaking because lymphatic vessels have very thin walls and are transparent. Selection of appropriate contrast agents is a key factor for successfully visualizing the lymphatics. In this study, the authors introduce a new imaging technique of lymphatic mapping in the whole bodies of fresh cadavers.
Ten fresh human cadavers were used for this study. The authors injected 0.1 ml of indocyanine green fluorescence solution subcutaneously at multiple spots along the watershed lines between lymphatic territories and hand and foot regions. After the body was scanned by the near-infrared camera system, fluorescent tissues were harvested and histologic examination was performed under the microscope equipped with the infrared camera system to confirm that they were the lymphatics.
Subcutaneously injected indocyanine green was immediately transported into the lymphatic vessels after gentle massage on the injection points. Sweeping massage along the lymphatic vessels facilitated indocyanine green transport inside the lymphatic vessel to move toward the lymph nodes. The lymphatic system was visualized well in the whole body. Histologic examinations confirmed that indocyanine green was detected in the lymphatic lumens specifically, even when located far from the injected points.
The lymphatic system could be visualized in whole-body fresh cadavers, as in living bodies, using indocyanine green fluorescence lymphography. Compatibility of indocyanine green lymphography would facilitate the use of cadaveric specimens for macroscopic and microscopic analyses.
在尸体中识别淋巴管是一项艰苦的工作，因为淋巴管壁非常薄且透明。选择合适的对比剂是成功可视化淋巴管的关键因素。在这项研究中，作者介绍了一种新的全身新鲜尸体淋巴管造影成像技术。
本研究使用了 10 具新鲜人体尸体。作者在沿淋巴管区域和手、足区域分水岭线的多个点皮下注射 0.1ml 吲哚菁绿荧光溶液。在使用近红外摄像系统对尸体进行扫描后，采集荧光组织并在配备红外摄像系统的显微镜下进行组织学检查，以确认其为淋巴管。
在注射点轻柔按摩后，皮下注射的吲哚菁绿立即被运送到淋巴管中。沿淋巴管进行扫动式按摩有助于吲哚菁绿在淋巴管内运输，向淋巴结移动。全身的淋巴系统都能很好地可视化。组织学检查证实，即使远离注射点，吲哚菁绿也能特异性地在淋巴管腔内被检测到。
使用吲哚菁绿荧光淋巴造影术可以在全身新鲜尸体中可视化淋巴系统，就像在活体中一样。吲哚菁绿淋巴造影术的兼容性将有助于使用尸体标本进行宏观和微观分析。
