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[Tests and imaging of the lymphatic system]
A P Pecking1, J P Desprez-Curely, R V Cluzan
1Service des isotopes, centre René-Huguenin, 35, rue Dailly, 92110 Saint-Cloud, France. a.pecking@stcloud-huguenin.org
La Revue De Medecine Interne
|August 7, 2002
Summary
Lymphatic imaging methods range from anatomic to functional studies. Indirect radionuclide lymphoscintigraphy offers a safe, non-invasive way to assess limb lymphatic function and variations during therapy.
Area of Science:
- Medical Imaging
- Lymphatic System Physiology
Background:
- Lymphatic imaging encompasses diverse anatomic and functional techniques.
- Lymphostasis diagnosis historically relied on lymphographies, with contrast lymphangiography offering detailed anatomical data but limited utility in limb edema.
Purpose of the Study:
- To review and classify various lymphatic imaging modalities.
- To highlight the advantages of indirect lymphoscintigraphy for assessing lymphatic function and guiding therapy.
Main Methods:
- Classification of lymphatic imaging into anatomic (e.g., contrast lymphangiography) and functional (e.g., indirect lymphographies) categories.
- Description of techniques including blue dye test, fluorescence microlymphoangiography, and indirect radionuclide lymphoscintigraphy.
- Evaluation of indirect lymphangiography with contrast medium for differentiating lipedema and lymphedema.
Main Results:
- Contrast lymphangiography provides precise anatomical detail but is invasive and not indicated for limb edema.
- Indirect radionuclide lymphography offers more reliable information than the blue dye test for lymphostasis diagnosis.
- Fluorescence microlymphoangiography visualizes skin lymphatics atraumatically.
- Indirect lymphangiography with contrast medium reliably assesses initial lymphatics and aids in lipedema/lymphedema differentiation.
- Indirect radionuclide lymphoscintigraphy is a safe, non-invasive method for assessing peripheral lymphatic morphology and function.
Conclusions:
- Indirect radionuclide lymphoscintigraphy is a preferred method for objective, non-invasive assessment of the limb lymphatic system.
- This technique is crucial for monitoring lymphatic system changes during therapeutic interventions like decongestive physiotherapy, surgery, or drug treatment.