Lymphoscintigraphic Findings That Predict Favorable Outcome after Lymphaticovenous Anastomosis

Radionuclide lymphoscintigraphy is an imaging technique used to radiologically evaluate the lymphatic system which can be utilized to evaluate signs of lymphatic obstruction that could be indication for lymphaticovenous anastomosis (LVA) operations. Our objective was to investigate and identify the radiographic signs in lymphoscinigraphy that predict favorable outcome after LVA. We retrospectively reviewed the medical charts of 80 patients with upper or lower-limb lymphedema who underwent initial lymphoscintigraphy before LVA during the 2011 to 2014 study period to evaluate statistical association between lymphoscintigraphic findings and the clinical result after LVA. Following LVA, clinical improvement was observed in 50 patients (48 female and 2 male) with no clinical improvement evident in the remaining 1 male and 29 females. Dilated lymph vessels and dermal backflow were identified as the abnormal finding in lymphoscintigraphy that were significantly correlated with improved clinical result after LVA. Our conclusion is that radionuclide lymphoscintigraphy prior to LVA is helpful in identifying patients for whom LVA is of benefit. Based on our findings, presence of dilated lymph vessels and presence of dermal backflow are significantly correlated with improved clinical result after LVA.