[Isotopic lymphography tests in post-thrombotic syndrome]

Area of Science:

• Medical Imaging
• Lymphatic System Physiology
• Vascular Medicine

Background:

• Assessing lymph transport in the legs is crucial for diagnosing vascular conditions.
• Isotopic lymphography provides a method to evaluate both superficial and deep lymphatic pathways.
• Deep vein thrombosis (DVT) and post-thrombotic syndrome can significantly impact lymphatic function.

Purpose of the Study:

• To evaluate the utility of isotopic lymphography in assessing pre-fascial and subfascial lymph transport in the leg.
• To investigate changes in lymphatic transport during acute deep vein thrombosis and in the post-thrombotic limb.
• To compare pre-fascial lymph-drainage with subfascial lymph-transport in affected limbs.

Main Methods:

• Utilized isotopic lymphography with labeled microcolloids injected subcutaneously (pre-fascial) or into the calf muscle (subfascial).
• Employed a standardized walking exercise to stimulate lymph transport.
• Employed quantitative measurement combining transmission and emission scintigraphy for detailed analysis.

Main Results:

• Deep lymphatic transport was consistently diminished or absent in the acute stage of DVT and in post-thrombotic limbs.
• Pre-fascial lymph-drainage was observed to be enhanced in these conditions.
• Exceptions to enhanced pre-fascial drainage included cases with recurrent erysipelas or tracer injection near an ulcer.

Conclusions:

• Isotopic lymphography is a valuable tool for assessing leg lymph transport, distinguishing between superficial and deep pathways.
• Deep lymphatic transport impairment is a key finding in DVT and post-thrombotic limbs.
• Altered lymphatic dynamics, with increased superficial drainage, characterize these vascular conditions.