[Diagnostic value and criteria for evaluating indirect lymphography in lymphedema]

To evaluate the deciding diagnostic criteria of indirect lymphography in lymphoedema of the leg, 91 investigations were reviewed. 72 examinations were from lymphoedematous legs as judged by clinical appearance and isotopic lymphography and 19 from healthy legs. After subepidermal infusion of adequate water soluble contrast media (e.g. Jotrolan) in healthy legs, 17 from 19 cases showed normal ellipsoid dye-deposits with normally structured lymph-collectors. In two cases pathological lymph-collectors were shown (specificity 89%). In the 72 legs with lymphoedema the most prominent pathological features were altered lymph-collectors and/or dermal backflow. Only two cases revealed a normal pattern (Sensitivity 97%). Indirect lymphography therefore may be recommended as a sensitive but less specific diagnostic tool for proving lymphoedema in a suspected clinical situation.