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[Contribution of lymphoscintigraphy in the exploration of lymphedema in children]
F Baulieu1, L Vaillant, N Gironet
1Service de Médecine nucléaire et Echographie, CHU Trousseau, 37044 Tours.
Insights
Lymphoscintigraphy is feasible and useful for diagnosing lymphedema in young children. This imaging technique helps understand lymphatic system abnormalities and aids in prognostic evaluation.
Area of Science:
- Pediatric imaging
- Lymphatic system diagnostics
- Medical imaging techniques
Background:
- Primary lymphedema affects children, necessitating accurate diagnostic tools.
- Understanding the pathophysiology of pediatric lymphedema is crucial for effective management.
Observation:
- Lymphoscintigraphy was performed on 41 children (3 months-16 years) with primary lymphedema.
- The study utilized 99mTC-labeled colloid injected subcutaneously, with imaging at 30 minutes and 4 hours post-injection.
- Analysis focused on lymph collector and node activity, stratified by age (< or > 2 years).
Findings:
- Abnormal lymph collector and node activity was observed in pediatric lymphedema patients.
- Classifications included simple hypoplasia, diffuse lymphatic dysplasia, mixed vascular dysmorphism, and amniotic band syndrome.
- The study demonstrated lymphoscintigraphy's role in diagnosing and evaluating the prognosis of pediatric lymphedema.
Implications:
- Lymphoscintigraphy is a valuable tool for the early diagnosis of lymphedema in infants and young children.
- The technique provides critical information for the overall exploration and management of pediatric lymphatic disorders.
- This study supports the integration of lymphoscintigraphy into the diagnostic workup for children with suspected lymphedema.
Objectives:
The objectives of this work were a) to assess the feasibility of lymphoscintigraphy in very young children, and b) to assess its usefulness in understanding the underlying pathophysiology.
Patients And Methods:
Forty-one children (age range 3 months-16 years) with primary lymphedema of the lower and/or upper limbs underwent lymphosinctigraphy using 99mTC-labeled colloid (Nanocis or Nanocol) injected subcutaneous at the foot and/or hand level. Recording time, which depended on the child's age, included at least static images during the thirty minutes following injection and four hours later.
Results:
Abnormal activity of the lymph collectors, nodes, and interstitial space were analyzed according to age (> or < 2 years). Abnormal findings were classed as simple hypoplasia (n=18) or other type of lymph disease: diffuse lymphatic dysplasia (n=6), mixed vascular dysmorphism (n=5), amniotic bride disease (n=1), and hypoplasia revealed by occurrence of a minor factor (n=11). These observations demonstrate the role of lymphoscintigraphy in the diagnosis and prognostic evaluation of lymphedema in children.
Conclusion:
Lymphoscintigraphy is a useful technique for very young children with lymphedema providing further information contributing to overall exploration.
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