Noninvasive evaluation of the lymphatic system with lymphoscintigraphy: A prospective, semiquantitative analysis in 386 extremities Robert A. Cambria,

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Presentation transcript:

Noninvasive evaluation of the lymphatic system with lymphoscintigraphy: A prospective, semiquantitative analysis in 386 extremities Robert A. Cambria, MD, Peter Gloviczki, MD, James M. Naessens, MPH, Heinz W. Wahner, MD Journal of Vascular Surgery Volume 18, Issue 5, Pages 773-782 (November 1993) DOI: 10.1016/0741-5214(93)90331-F Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Dynamic 5-minute images from 64-year-old man with longstanding bilateral leg swelling. There is rapid ascent of tracer bilaterally with some collateral channels in left thigh. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Total body lymphoscintigram 1 hour after injection of tracer. This 38-year-old woman was admitted with 15-year history of bilateral lower extremity swelling. Lymph vessels, nodes, and transport kinetics appear normal. There are several collateral lymph channels at left popliteal region. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Total body image 3 hours after injection in 34-year-old man with 18-month history of left leg swelling (primary lymphedema). There is localized area of dermal distribution in left calf with diminished number of lymph nodes in left inguinal region. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Lymphoscintigram 1 hour after injection in 52-year-old woman with Hodgkin's disease. Lymphocele is noted in left groin, at site of previous lymph node biopsy. There is dermal pattern in left calf. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Graphic representation of TI in patients with lower extremity swelling. There is no difference in transport index between primary and secondary lymphedema, or between other causes for limb swelling and normal extremities. There is marked difference between TI in patients with lymphedema, and those with swelling caused by other causes or those with normal extremities. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Lymphoscintigram of 18-year-old man with lymphangiectasia, protein-losing enteropathy, and chylous ascites. Dilated lower extremity lymphatic vessels and reflux of tracer into abdominal cavity can be seen. Reflux into mesenteric lymphatics was later confirmed at lymphangiography. Journal of Vascular Surgery 1993 18, 773-782DOI: (10.1016/0741-5214(93)90331-F) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions