Forner-Cordero I, Oliván-Sasot P, Ruiz-Llorca C, Muñoz-Langa J
Unidad de Linfedema, Hospital Universitari i Politècnic La Fe, Universidad de Valencia, Valencia, España.
Servicio de Medicina Nuclear, Hospital Universitari i Politècnic La Fe, Valencia, España.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018 Nov-Dec;37(6):341-348. doi: 10.1016/j.remn.2018.06.008. Epub 2018 Aug 28.
Lipedema is a syndrome that is characterised by edema, an accumulation of fat, pain and haematomas in the lower limbs that principally affects women. Diagnosis is currently based on clinical criteria, since there is no accurate diagnostic imaging for the condition. The aim of our study was to describe the lymphoscintigraphic findings in patients with lipedema.
A prospective cohort study of women with clinical criteria of lipedema who underwent lymphoscintigraphy. Two independent nuclear physicians described and classified the lymphoscintigraphy findings in different grades of severity, according to the migration and distribution of the radiopharmaceutical. Eighty three patients were included with a median age of 49.7years (range: 18-80) and a mean body mass index (BMI) of 29.9kg/m (95%CI: 28.4-31.3) RESULTS: Lymphoscintigraphy showed alterations in 47% of the patients, most were low (35.9%) or low-moderate grade (48.7%). None of the patients were severely affected (no migration of the radiopharmaceutical). The degree of lymphoscintigraphic involvement bore no relation to age (P=.674), Stemmer's sign (P=.506), or BMI (P=.832). We found lymphoscintigraphy findings in all the clinical stages of lipedema, with no significant differences between the grade of lymphoscintigraphic involvement and the clinical stage of lipedema (P=.142).
Although lymphoscintigraphy has been used to differentiate lipedema from lymphedema, we found frequent alterations in the patients with lipedema, therefore the presence of findings dues not discount a diagnosis of lip1aedema.
脂肪性水肿是一种以下肢水肿、脂肪堆积、疼痛和血肿为特征的综合征，主要影响女性。目前诊断基于临床标准，因为尚无针对该病症的准确诊断性影像学检查。我们研究的目的是描述脂肪性水肿患者的淋巴闪烁造影结果。
对符合脂肪性水肿临床标准且接受淋巴闪烁造影的女性进行一项前瞻性队列研究。两名独立的核医学医师根据放射性药物的迁移和分布，对不同严重程度等级的淋巴闪烁造影结果进行描述和分类。纳入83例患者，中位年龄49.7岁（范围：18 - 80岁），平均体重指数（BMI）为29.9kg/m²（95%置信区间：28.4 - 31.3）。结果：淋巴闪烁造影显示47%的患者有改变，大多数为轻度（35.9%）或轻 - 中度（48.7%）。没有患者受到严重影响（放射性药物无迁移）。淋巴闪烁造影受累程度与年龄（P = 0.674）、施特默征（P = 0.506）或BMI（P = 0.832）无关。我们在脂肪性水肿的所有临床阶段均发现了淋巴闪烁造影结果，淋巴闪烁造影受累等级与脂肪性水肿临床阶段之间无显著差异（P = 0.142）。
尽管淋巴闪烁造影已被用于区分脂肪性水肿和淋巴水肿，但我们发现脂肪性水肿患者中常有改变，因此存在这些结果并不排除脂肪性水肿的诊断。
