[Value of exploring the deep lymphatic system of the lower limbs using lymphoscintigraphy. Preliminary study of 18...

Lymphoscintigraphy of lower limbs generally involves bilateral subcutaneous injection of a radioactive colloid into the first or second interdigital space: only the superficial internal saphenous pathway is visualized in this way (superficial lymphoscintigraphy: SL). However, the external saphenous and deep pathways can be explored by an external retromalleolar injection as demonstrated in radiology. Isotopic exploration of the external saphenous pathway and deep lymphatics (deep lymphoscintigraphy: DL) was carried out in 18 patients with arteritis also investigated by SL. The study forms part of a prospective trial of edema developing after femoro-popliteal shunts. The deep lymphatics are correctly and easily visualized, and in about 20% of cases there exist anomalies of distribution of superficial or deep lymphatic flow, morphologic anomalies developing postoperatively in one pathway only, or in both pathways. DL is a simple, reliable method of investigation of deep lymphatics, and complete exploration of lymphatics of lower limbs should include both SL and DL.