Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Medical Imaging, Zuyderland Medical Center, Geleen, The Netherlands.
Lymphat Res Biol. 2022 Jun;20(3):275-281. doi: 10.1089/lrb.2021.0012. Epub 2021 Sep 2.
The lymphatic system consists of the superficial and deep lymphatic system. Several diagnostic methods are used to assess the lymphatic system. Lymphoscintigraphy and indocyanine green lymphography are widely applied, both showing disadvantages, such as a poor resolution and lack of field of view. Magnetic resonance lymphography (MRL) shows satisfactory temporal and spatial resolution. The aim of this study was to assess both the superficial and deep lymphatic system in the upper extremity of healthy subjects, using an MRL protocol. Ten healthy volunteers underwent an MRL examination, using a three Tesla MRI unit. Water-soluble gadolinium was used as a contrast agent. MRL images were evaluated by an experienced radiologist on image quality, enhancement of veins and lymphatic vessels, and characteristics of the latter. Overall image quality was good to excellent. In all subjects, veins and lymphatic vessels could be distinguished. Superficial and deep lymphatic vessels were seen in 9 out of 10 subjects. Lymphatic vessels with a diameter between 0.9 and 4.3 mm were measured. Both veins and lymphatic vessels showed their characteristic appearance. Enhancement of veins was seen directly after contrast agent injection, which decreased over time. Lymphatic vessel enhancement slowly increased over time. Mean total MRL examination (room) time was 110 minutes (81 minutes scan time). The MRL protocol accurately visualizes both deep and superficial lymphatic vessels showing their characteristic appearances with high spatial resolution, indicating the MRL can be of value in diagnosing and staging peripheral lymphedema.
淋巴系统由浅部和深部淋巴系统组成。有几种诊断方法可用于评估淋巴系统。淋巴闪烁显像和吲哚菁绿淋巴造影术被广泛应用，但都存在分辨率差和视野缺乏的缺点。磁共振淋巴造影术（MRL）具有令人满意的时间和空间分辨率。本研究旨在使用 MRL 方案评估健康受试者上肢的浅部和深部淋巴系统。10 名健康志愿者使用 3T MRI 单元进行 MRL 检查。水溶性钆被用作对比剂。由有经验的放射科医生对图像质量、静脉和淋巴管的增强以及后者的特征进行 MRL 图像评估。总体图像质量良好至优秀。在所有受试者中，均能区分静脉和淋巴管。9 名受试者中均可见浅部和深部淋巴管。测量了直径为 0.9 至 4.3 毫米的淋巴管。可见具有特征性外观的浅部和深部淋巴管。静脉增强可在造影剂注射后直接观察到，随着时间的推移逐渐减少。淋巴管增强随着时间的推移缓慢增加。平均 MRL 检查（包括房间准备时间）总时长为 110 分钟（扫描时间 81 分钟）。MRL 方案可准确显示具有高空间分辨率的深部和浅部淋巴管及其特征性外观，表明 MRL 可用于诊断和分期周围性淋巴水肿。
