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Primary lower limb lymphoedema: classification with non-contrast MR lymphography.

Lionel Arrivé1,2, S Derhy3,4, B Dahan5

  • 1Department of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France. lionel.arrive@aphp.fr.

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|July 12, 2017
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Summary

Non-contrast MR lymphography effectively classifies primary lower limb lymphoedema. This imaging technique categorizes lymphoedema into hyperplasic, aplastic, hypoplasic, and normal patterns, aiding clinical management.

Keywords:
Lower limb lymphoedemaLymphatic vesselsLymphoedemaMR lymphographyNon-contrast MR lymphography

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Area of Science:

  • Radiology
  • Medical Imaging
  • Vascular Medicine

Background:

  • Primary lower limb lymphoedema presents a significant clinical challenge.
  • Accurate classification is crucial for effective patient management and treatment strategies.

Purpose of the Study:

  • To evaluate the performance of non-contrast MR lymphography in classifying primary lower limb lymphoedema.
  • To correlate imaging findings with clinical severity and lymphatic vessel characteristics.

Main Methods:

  • 121 patients with primary lower limb lymphoedema underwent non-contrast MR lymphography.
  • A free-breathing 3D fast spin-echo sequence was utilized.
  • Lymphoedema severity and lymphatic trunk characteristics (aplasia, hypoplasia, normal, hyperplasia) were retrospectively graded.

Main Results:

  • Non-contrast MR lymphography demonstrated feasibility in differentiating lymphatic vessel patterns: aplasia (21%), hypoplasia (15%), normal (53%), and hyperplasia (11%).
  • A strong correlation was observed between clinical stage and lymphoedema severity (Cramer's V = 0.73).
  • Severe lymphoedema was more frequent in aplastic (46%) and hyperplasic (37%) patterns compared to hypoplasic (15%) and normal (0%) patterns.

Conclusions:

  • Non-contrast MR lymphography is a valuable tool for classifying primary lower limb lymphoedemas.
  • The technique can categorize lymphoedema into distinct patterns: hyperplasic, aplastic, hypoplasic, and normal.
  • This classification has the potential to optimize the clinical management of primary lower limb lymphoedemas.