Chiewvit S, Kumnerdnakta S
Division of Nuclear Medicine, Department of Radiology, Siriraj Hospital, Mahidol University. Bangkok, Thailand.
Division of Plastic Surgery, Department of Surgery, Siriraj Hospital, Mahidol University. Bangkok, Thailand.
Lymphology. 2017;50(1):1-8.
Radionuclide lymphoscintigraphy is an imaging technique used to radiologically evaluate the lymphatic system which can be utilized to evaluate signs of lymphatic obstruction that could be indication for lymphaticovenous anastomosis (LVA) operations. Our objective was to investigate and identify the radiographic signs in lymphoscinigraphy that predict favorable outcome after LVA. We retrospectively reviewed the medical charts of 80 patients with upper or lower-limb lymphedema who underwent initial lymphoscintigraphy before LVA during the 2011 to 2014 study period to evaluate statistical association between lymphoscintigraphic findings and the clinical result after LVA. Following LVA, clinical improvement was observed in 50 patients (48 female and 2 male) with no clinical improvement evident in the remaining 1 male and 29 females. Dilated lymph vessels and dermal backflow were identified as the abnormal finding in lymphoscintigraphy that were significantly correlated with improved clinical result after LVA. Our conclusion is that radionuclide lymphoscintigraphy prior to LVA is helpful in identifying patients for whom LVA is of benefit. Based on our findings, presence of dilated lymph vessels and presence of dermal backflow are significantly correlated with improved clinical result after LVA.
放射性核素淋巴闪烁造影术是一种用于放射学评估淋巴系统的成像技术，可用于评估可能提示进行淋巴管静脉吻合术（LVA）手术的淋巴阻塞迹象。我们的目的是研究并确定淋巴闪烁造影术中能够预测LVA术后良好预后的影像学征象。我们回顾性分析了2011年至2014年研究期间80例接受LVA手术前初次淋巴闪烁造影术的上肢或下肢淋巴水肿患者的病历，以评估淋巴闪烁造影术结果与LVA术后临床结果之间的统计学关联。LVA术后，50例患者（48例女性和2例男性）出现临床改善，其余1例男性和29例女性未出现明显临床改善。淋巴管扩张和真皮反流被确定为淋巴闪烁造影术中的异常表现，与LVA术后临床结果改善显著相关。我们的结论是，LVA术前的放射性核素淋巴闪烁造影术有助于识别能从LVA中获益的患者。根据我们的研究结果，淋巴管扩张和真皮反流的存在与LVA术后临床结果改善显著相关。
