Laor T, Hoffer F A, Burrows P E, Kozakewich H P
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.
AJR Am J Roentgenol. 1998 Oct;171(4):1111-7. doi: 10.2214/ajr.171.4.9763006.
Our objective was to offer a preliminary description of MR lymphangiography; its uses and limitations; and its findings in infants, children, and young adults.
Twenty-nine patients underwent 32 MR lymphangiographic examinations for evaluation of vascular malformations, other masses, soft-tissue swelling, gigantism, fluid accumulation, or pain. MR lymphangiography was based on a heavily T2-weighted fast spin-echo sequence and a maximum-intensity-projection algorithm. We assessed the axial and off-axial lymphatic channels in conjunction with MR venography to help differentiate veins from lymphatics. Correlation was made with published lymphangiograms and anatomic diagrams to assist interpretation and (when available) with histologic specimens (n = 11) for validation.
Presumed lymphatic channels were seen universally, although 14 examinations showed incomplete venous signal suppression. Lymphatic channels appeared normal in eight children and in 20 of the 21 asymptomatic contralateral limbs. Ten patients had an increased number and size of off-axial channels, including seven children with large, diffuse low-flow vascular malformations. Enlarged axial and off-axial channels were seen in five patients, four of whom had Klippel-Trénaunay syndrome. Six patients, each with an extensive hemangioendothelioma, Klippel-Trénaunay syndrome, Gorham syndrome, or unilateral body edema, showed absence or interruption of axial channels.
MR lymphangiography appears to be a useful noninvasive technique to study superficial and deep lymphatic channels in children with local or diffuse vascular lesions or swelling of extremities. Its limitations notwithstanding, the technique may offer further insight into the nature of vascular anomalies, may direct therapy, and may predict prognosis.
我们的目的是对磁共振淋巴造影进行初步描述；阐述其用途和局限性；以及其在婴儿、儿童和青年中的表现。
29例患者接受了32次磁共振淋巴造影检查，以评估血管畸形、其他肿块、软组织肿胀、巨人症、积液或疼痛。磁共振淋巴造影基于重T2加权快速自旋回波序列和最大强度投影算法。我们结合磁共振静脉造影评估轴向和非轴向淋巴管，以帮助区分静脉和淋巴管。与已发表的淋巴管造影和解剖图进行对照以辅助解读，并（如有可用）与组织学标本（n = 11）进行对照以验证。
普遍可见推测的淋巴管，尽管14次检查显示静脉信号抑制不完全。8名儿童以及21例无症状对侧肢体中的20例，其淋巴管看起来正常。10例患者的非轴向淋巴管数量和大小增加，其中7名儿童患有大型、弥漫性低流量血管畸形。5例患者可见轴向和非轴向淋巴管增粗，其中4例患有Klippel-Trénaunay综合征。6例患者，分别患有广泛的血管内皮瘤、Klippel-Trénaunay综合征、Gorham综合征或单侧身体水肿，显示轴向淋巴管缺失或中断。
磁共振淋巴造影似乎是一种有用的非侵入性技术，可用于研究患有局部或弥漫性血管病变或肢体肿胀的儿童的浅表和深部淋巴管。尽管存在局限性，但该技术可能会进一步深入了解血管异常的性质，指导治疗，并预测预后。
