From the Department of Radiology, Divisions of Cardiothoracic Imaging (E.L., P.P.A.), Interventional Radiology (W.S.), and Body Imaging (W.R.M.), University of Michigan, University Hospital Floor B1, Reception C, 1500 E Medical Center Dr, SPC 5030, Ann Arbor, MI 48109; University of Pennsylvania Perelman School of Medicine, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); and Department of Radiology, Division of Pediatric Radiology, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, Mich (M.L.T.).
Radiographics. 2022 Mar-Apr;42(2):487-505. doi: 10.1148/rg.210104. Epub 2022 Feb 18.
Lymphatic abnormalities encompass a wide range of disorders spanning solitary common cystic lymphatic malformations (LMs) to entities involving multiple organ systems such as lymphangioleiomyomatosis. Many of these disorders are rare, yet some, such as secondary lymphedema from the treatment of malignancy (radiation therapy and/or lymph node dissection), affect millions of patients worldwide. Owing to complex and variable anatomy, the lymphatics are not as well understood as other organ systems. Further complicating this is the variability in the description of lymphatic disease processes and their nomenclature in the medical literature. In recent years, medical imaging has begun to facilitate a deeper understanding of the physiology and pathologic processes that involve the lymphatic system. Radiology is playing an important and growing role in the diagnosis and treatment of many lymphatic conditions. The authors describe both normal and common variant lymphatic anatomy. Various imaging modalities including nuclear medicine lymphoscintigraphy, conventional lymphangiography, and MR lymphangiography used in the diagnosis and treatment of lymphatic disorders are highlighted. The authors discuss imaging many of the common and uncommon lymphatic disorders, including primary LMs described by the International Society for the Study of Vascular Anomalies 2018 classification system (microcystic, mixed, and macrocystic LMs; primary lymphedema). Secondary central lymphatic disorders are also detailed, including secondary lymphedema and chylous leaks, as well as lymphatic disorders not otherwise easily classified. The authors aim to provide the reader with an overview of the anatomy, pathology, imaging findings, and treatment of a wide variety of lymphatic conditions. RSNA, 2022.
淋巴异常包括广泛的疾病，从单一的常见囊性淋巴管畸形 (LM) 到涉及多个器官系统的实体，如淋巴管平滑肌瘤病。这些疾病中有许多很少见，但有些，如恶性肿瘤（放射治疗和/或淋巴结清扫术）治疗后的继发性淋巴水肿，影响了全球数以百万计的患者。由于淋巴管的解剖结构复杂且多变，因此不如其他器官系统那么容易理解。使情况更加复杂的是，在医学文献中，淋巴疾病过程的描述及其命名存在很大的差异。近年来，医学影像学开始帮助人们更深入地了解涉及淋巴系统的生理和病理过程。放射学在许多淋巴疾病的诊断和治疗中发挥着重要且不断增长的作用。作者描述了正常和常见变异的淋巴解剖结构。强调了用于诊断和治疗淋巴疾病的各种成像方式，包括核医学淋巴闪烁显像、常规淋巴造影术和磁共振淋巴造影术。作者讨论了许多常见和不常见的淋巴疾病的成像，包括国际血管异常研究学会 2018 年分类系统描述的原发性 LM（微囊型、混合性和巨囊型 LM；原发性淋巴水肿）。还详细介绍了继发性中央淋巴系统疾病，包括继发性淋巴水肿和乳糜漏，以及其他不易分类的淋巴疾病。作者旨在为读者提供广泛的淋巴疾病的解剖、病理、影像学表现和治疗概述。RSNA，2022 年。
