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Rest/Stress Intradermal Lymphoscintigraphy for the Functional Imaging of the Lymphatic System.
Girolamo Tartaglione1, Francesco Pio Ieria1, Giuseppe Visconti2
1From the Department of Nuclear Medicine, Cristo Re Hospital.
Clinical Nuclear Medicine
|October 2, 2022
Summary
Rest/stress intradermal lymphoscintigraphy effectively diagnoses lymphedema by visualizing lymphatic pathways. This method aids surgeons in planning advanced treatments for both primary and secondary lymphedema.
Area of Science:
- Nuclear Medicine
- Vascular Surgery
- Lymphedema Diagnosis
Background:
- Lymphoscintigraphy is the standard for lymphedema diagnosis, but lacks standardization.
- A novel rest/stress intradermal lymphoscintigraphy approach is utilized.
Purpose of the Study:
- To evaluate the efficacy of rest/stress intradermal lymphoscintigraphy in diagnosing lymphedema.
- To assess lymphatic pathway visualization and exercise effects on drainage.
Main Methods:
- 231 patients with suspected lymphedema underwent intradermal injection of 99mTc-nanocolloid.
- Resting and post-exercise (2 and 30-40 min) static planar scans were performed.
- Abnormal findings were classified as minor or major based on severity.
Main Results:
- Superficial lymphatics and nodes visualized in ~80% of limbs; deep vessels in 26%.
- Major findings (stagnation, extravasation, dermal backflow) seen in 53.2% of limbs.
- Primary lymphedema showed more deep pathway visualization; secondary showed more major findings.
Conclusions:
- Rest/stress intradermal lymphoscintigraphy provides detailed lymphatic imaging.
- This technique offers functional insights for microsurgical interventions like lymphatic-venous anastomosis.
- The method aids in evaluating lymphatic drainage response to muscular exercise.
