Molecular and Clinical Sciences Research Institute, St George's University, London, UK.
Department of Neuroradiology, King's College Hospital, London, UK.
J Magn Reson Imaging. 2021 Jun;53(6):1766-1790. doi: 10.1002/jmri.27542. Epub 2021 Feb 24.
Clinical examination and lymphoscintigraphy are the current standard for investigating lymphatic function. Magnetic resonance imaging (MRI) facilitates three-dimensional (3D), nonionizing imaging of the lymphatic vasculature, including functional assessments of lymphatic flow, and may improve diagnosis and treatment planning in disease states such as lymphedema.
To summarize the role of MRI as a noninvasive technique to assess lymphatic drainage and highlight areas in need of further study.
Systematic review.
In October 2019, a systematic literature search (PubMed) was performed to identify articles on magnetic resonance lymphangiography (MRL).
FIELD STRENGTH/SEQUENCE: No field strength or sequence restrictions.
Article quality assessment was conducted using a bespoke protocol, designed with heavy reliance on the National Institutes of Health quality assessment tool for case series studies and Downs and Blacks quality checklist for health care intervention studies.
The results of the original research articles are summarized.
From 612 identified articles, 43 articles were included and their protocols and results summarized. Field strength was 1.5 or 3.0 T in all studies, with 25/43 (58%) employing 3.0 T imaging. Most commonly, imaging of the peripheries, upper and lower limbs including the pelvis (32/43, 74%), and the trunk (10/43, 23%) is performed, including two studies covering both regions. Imaging protocols were heterogenous; however, T -weighted and contrast-enhanced T -weighted images are routinely acquired and demonstrate the lymphatic vasculature. Edema, vessel, quantity and morphology, and contrast uptake characteristics are commonly reported indicators of lymphatic dysfunction.
MRL is uniquely placed to yield large field of view, qualitative and quantitative, 3D imaging of the lymphatic vasculature. Despite study heterogeneity, consensus is emerging regarding MRL protocol design. MRL has the potential to dramatically improve understanding of the lymphatics and detect disease, but further optimization, and research into the influence of study protocol differences, is required before this is fully realized.
2 TECHNICAL EFFICACY: Stage 2.
临床检查和淋巴闪烁显像术是当前用于研究淋巴功能的标准方法。磁共振成像（MRI）可实现对淋巴管的三维（3D）、非电离成像，包括对淋巴流动的功能评估，并且可能改善淋巴水肿等疾病状态的诊断和治疗计划。
总结 MRI 作为一种非侵入性技术评估淋巴引流的作用，并强调需要进一步研究的领域。
系统评价。
2019 年 10 月，进行了一项系统文献检索（PubMed），以确定关于磁共振淋巴造影术（MRL）的文章。
磁场强度/序列：无磁场强度或序列限制。
使用专门的方案进行文章质量评估，该方案主要依赖于美国国立卫生研究院针对病例系列研究的质量评估工具和针对医疗保健干预研究的 Downs 和 Blacks 质量清单。
总结原始研究文章的结果。
从 612 篇已识别的文章中，纳入了 43 篇文章，并总结了它们的方案和结果。所有研究的磁场强度均为 1.5 或 3.0T，其中 25/43（58%）采用 3.0T 成像。最常见的是对四肢、上下肢（包括骨盆）（32/43，74%）和躯干（10/43，23%）进行成像，包括两项涵盖两个区域的研究。成像方案存在异质性；然而，常规采集 T 加权和对比增强 T 加权图像，并显示淋巴管。水肿、血管、数量和形态以及对比摄取特征是淋巴功能障碍的常见报告指标。
MRL 独特地能够对淋巴血管进行大视野、定性和定量、3D 成像。尽管研究存在异质性，但在 MRL 方案设计方面正在达成共识。MRL 有可能极大地提高对淋巴管的理解并检测疾病，但在充分实现这一点之前，还需要进一步优化并研究研究方案差异的影响。
2 技术功效：2 级。
