Villa G, Campisi C C, Ryan M, Boccardo F, Di Summa P, Frascio M, Sambuceti G, Campisi C
U.O. of Nuclear Medicine, Polyclinic Hospital 'San Martino', Largo R. Benzi, 10, 16132 Genoa, Italy.
Reconstructive and Aesthetic Surgery-GVM Care & Research, Private Hospitals, Reggio Emilia, Rapallo (GE), Turin, Italy.
Nucl Med Mol Imaging. 2019 Feb;53(1):47-56. doi: 10.1007/s13139-018-0565-2. Epub 2019 Jan 7.
Lymphoscintigraphy is the gold standard for imaging in the diagnosis of peripheral lymphedema. However, there are no clear guidelines to standardize usage across centers, and as such, large variability exists. The aim of this perspectives paper is to draw upon the knowledge and extensive experience of lymphoscintigraphy here in Genoa, Italy, from our center of excellence in the assessment and treatment of lymphatic disorders for over 30 years to provide general guidelines for nuclear medicine specialists.
The authors describe the technical characteristics of lymphoscintigraphy in patients with limb swelling. Radioactive tracers, dosage, administration sites, and the rationale for a two-compartment protocol with the inclusion of subfascial lymphatic vessels are all given in detail.
Examples of lymphoscintigraphic investigations with various subgroups of patients are discussed. The concept of a transport index (TI) for semi-quantitative analysis of normal/pathological lymphatic flow is introduced. Different concepts of injection techniques are outlined.
It is past time that lymphoscintigraphy in the diagnosis of lymphatic disorders becomes standardized. This represents our first attempt to outline a clear protocol and delineate the relevant points for lymphoscintigraphy in this patient population.
淋巴闪烁造影术是诊断周围性淋巴水肿成像的金标准。然而，目前尚无明确的指南来规范各中心的使用，因此存在很大的变异性。本观点论文的目的是借鉴意大利热那亚我们在淋巴疾病评估和治疗方面拥有30多年卓越经验的中心在淋巴闪烁造影术方面的知识和丰富经验，为核医学专家提供一般指南。
作者描述了肢体肿胀患者淋巴闪烁造影术的技术特征。详细介绍了放射性示踪剂、剂量、给药部位以及包含筋膜下淋巴管的两室方案的原理。
讨论了不同亚组患者的淋巴闪烁造影检查实例。引入了用于正常/病理性淋巴流半定量分析的转运指数（TI）概念。概述了不同的注射技术概念。
淋巴闪烁造影术在淋巴疾病诊断中的标准化早就该进行了。这是我们首次尝试概述一个明确的方案，并阐述该患者群体淋巴闪烁造影术的相关要点。
