[Lymphoscintigraphic exploration in the limbs lymphatic disease]

Lymphoscintigraphy is based upon the physiological transport of small radioactive particles injected into interstitium toward lymphatic vessels and nodes. Lymphoscintigraphy directly investigates lymphatic system while other methods (ultrasounds, CT, MRI) investigate tissular consequences of lymphatic disease. The scintigraphic procedure has to be standardized in order to be reproducible. Lymphatic vessels, lymphatic nodes and interstitium are systematically analysed. Interpretation is visual and qualitative. Multiple abnormalities can be observed. However, none of them can consistently differentiate between primary and secondary lymphedema. Differential diagnosis is usually obtained by taking together clinical and lymphoscintigraphic data. By providing informations about lymphatic component and physiopathology of edema, lymphoscintigraphy contributes to the management of lymphedema. Hybrid imaging is a new imaging modality of edema. Recently used, it combines functional (scintigraphy) and anatomical (CT) data and seems to be able to provide further informations.