Bourgeois P, Leduc O, Leduc A
Nuclear Medicine Service, Institut Jules Bordet and CHU St. Pierre, Brussels, Belgium.
Cancer. 1998 Dec 15;83(12 Suppl American):2805-13. doi: 10.1002/(sici)1097-0142(19981215)83:12b+<2805::aid-cncr30>3.3.co;2-6.
Upper limb edema remains the most frequent complication after treatments for breast carcinoma. Various imaging techniques can be used to prevent these complications, to manage them, and to diagnose the possible lymphonodal evolution that may underlie these events. In the present paper, these techniques are reviewed.
Based on clinical experience as well as on the data from the literature, these imaging techniques are presented, and their contributions are analyzed.
The pre- and post-operative imaging and research techniques of the so-called sentinel nodes (using blue dye, and/or lymphoscintigraphy, and/or gamma probe) appear to be very promising for defining patients in whom axillary node clearance either might be avoided or is indicated. Lymphoscintigraphic investigations also can be used after surgery and/or radiation therapy to define patients who either are at risk to develop upper limb edema or present with latent edema. In patients with clinically obvious edema, even if it is limited, lymphoscintigraphic techniques can provide a morphologic and functional definition of the condition. Venous echo Doppler can be used when abnormalities of the venous return are suspected. In diagnosing the lymphonodal evolution of the disease, techniques like immunoscintigraphy, positron emission tomography (using 18-fluoro-2-deoxy-D-glucose), X-ray computed tomography, and nuclear magnetic resonance imaging can contribute.
Various imaging techniques can be used to prevent and/or to manage the upper limb edema that may complicate the treatment(s) of the patients with breast carcinoma.
上肢水肿仍然是乳腺癌治疗后最常见的并发症。各种成像技术可用于预防这些并发症、处理并发症以及诊断可能作为这些情况基础的淋巴结演变。本文对这些技术进行综述。
基于临床经验以及文献数据，介绍这些成像技术并分析其作用。
所谓前哨淋巴结的术前和术后成像及研究技术（使用蓝色染料、和/或淋巴闪烁造影、和/或γ探针）对于确定哪些患者可以避免或需要进行腋窝淋巴结清扫似乎非常有前景。淋巴闪烁造影检查也可在手术和/或放射治疗后用于确定有发生上肢水肿风险或存在潜在水肿的患者。对于临床上有明显水肿（即使水肿有限）的患者，淋巴闪烁造影技术可以提供该病症的形态学和功能学定义。当怀疑静脉回流异常时可使用静脉回波多普勒检查。在诊断疾病的淋巴结演变方面，免疫闪烁造影、正电子发射断层扫描（使用18-氟-2-脱氧-D-葡萄糖）、X线计算机断层扫描和核磁共振成像等技术可发挥作用。
各种成像技术可用于预防和/或处理可能使乳腺癌患者治疗复杂化的上肢水肿。
