High resolution unenhanced computed tomography in patients with swollen legs
Identifieur interne : 000697 ( France/Analysis ); précédent : 000696; suivant : 000698High resolution unenhanced computed tomography in patients with swollen legs
Auteurs : E. D. Monnin-Delhom [France] ; B. P. Gallix [France] ; C. Achard [France] ; J. M. Bruel [France] ; C. Janbon [France]Source :
- Lymphology [ 0024-7766 ] ; 2002.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Diagnostic différentiel, Femelle, Humains, Jambe, Lipodystrophie (imagerie diagnostique), Lymphoedème (imagerie diagnostique), Mâle, Sensibilité et spécificité, Sujet âgé, Sujet âgé de 80 ans ou plus, Thrombose veineuse (imagerie diagnostique), Tomodensitométrie ().
- MESH :
- imagerie diagnostique : Lipodystrophie, Lymphoedème, Thrombose veineuse.
- Pascal (Inist)
- Adolescent, Adulte, Adulte d'âge moyen, Diagnostic différentiel, Femelle, Humains, Jambe, Lymphoedème, Mâle, Sensibilité et spécificité, Sujet âgé, Sujet âgé de 80 ans ou plus, Thrombose, Tomodensitométrie, Veine profonde, Lipodystrophie, Oedème, Membre inférieur, Tomodensitométrie, Haute résolution, Diagnostic différentiel, Homme.
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Computerized axial tomography, Deep vein, Diagnosis, Differential, Differential diagnostic, Edema, Female, High resolution, Human, Humans, Leg, Lipodystrophy, Lipodystrophy (diagnostic imaging), Lower limb, Lymphedema, Lymphedema (diagnostic imaging), Male, Middle Aged, Sensitivity and Specificity, Thrombosis, Tomography, X-Ray Computed (methods), Venous Thrombosis (diagnostic imaging).
- MESH :
- diagnostic imaging : Lipodystrophy, Lymphedema, Venous Thrombosis.
- methods : Tomography, X-Ray Computed.
- Adolescent, Adult, Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Leg, Male, Middle Aged, Sensitivity and Specificity.
Abstract
Purpose: To evaluate the accuracy of computed tomography (CT) scan imaging in distinguishing lymphedema from deep venous thrombosis (DVT) and lipodystrophy (lipedema) in patients with swollen legs. Material and Methods: CT scans of the lower limbs were performed in 55 patients with 76 swollen legs (44 lymph edemas, 12 DVT and 20 lipedemas). Thirty-four normal contralateral legs were also similarly evaluated. Primary lymphedema was verified by lymphography or lymphoscintigraphy, whereas secondary lymphedema was documented by a typical clinical history. DVT was established by ultrasound Doppler imaging. The diagnosis of lipedema was made with bilateral swollen legs where lymphoscintigraphy and Doppler examination were both unremarkable. Qualitative CT analysis was based on skin thickening, subcutaneous edema accumulation with a honeycombed pattern, and muscle compartment enlargement. Results: Sensitivity and specificity of CT scan for the diagnosis of lymph edema was 93 and 100%, respectively; for lipedema it was 95 and 100%, respectively; and for DVT it was 91 and 99%, respectively. Skin thickening was found in 42 lymphedemas (95%), in 9 DVT (75%), and in 2 lipedemas (16%). Subcutaneous edema accumulation was demonstrated in 42 legs (95%) with lymphedema and in 5 (42%) with DVT but in none with lipedema. A honeycombed pattern was present only in lymph edema (18 legs or 41%); muscle enlargement was present in all patients with DVT, in no patient with lipedema, and in 4 (9%) with lymph edema. Conclusion: Edema accumulation is readily demonstrated with plain CT scan and is not present in lipedema. Specific CT features of the subcutaneous fat and muscle compartments allow accurate differentiation between lymphedema and DVT.
Affiliations:
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Pascal:02-0567598Le document en format XML
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D." last="Monnin-Delhom">E. D. Monnin-Delhom</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Service d'Imagerie Medicale, Saint Eloi Hospital</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Gallix, B P" sort="Gallix, B P" uniqKey="Gallix B" first="B. P." last="Gallix">B. P. Gallix</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Service d'Imagerie Medicale, Saint Eloi Hospital</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Achard, C" sort="Achard, C" uniqKey="Achard C" first="C." last="Achard">C. Achard</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Service d'Imagerie Medicale, Saint Eloi Hospital</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Bruel, J M" sort="Bruel, J M" uniqKey="Bruel J" first="J. M." last="Bruel">J. M. Bruel</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Service d'Imagerie Medicale, Saint Eloi Hospital</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Janbon, C" sort="Janbon, C" uniqKey="Janbon C" first="C." last="Janbon">C. Janbon</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Service de Medecine Interne, Saint Eloi Hospital</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Lymphology</title><title level="j" type="abbreviated">Lymphology</title><idno type="ISSN">0024-7766</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Lymphology</title><title level="j" type="abbreviated">Lymphology</title><idno type="ISSN">0024-7766</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Computerized axial tomography</term><term>Deep vein</term><term>Diagnosis, Differential</term><term>Differential diagnostic</term><term>Edema</term><term>Female</term><term>High resolution</term><term>Human</term><term>Humans</term><term>Leg</term><term>Lipodystrophy</term><term>Lipodystrophy (diagnostic imaging)</term><term>Lower limb</term><term>Lymphedema</term><term>Lymphedema (diagnostic imaging)</term><term>Male</term><term>Middle Aged</term><term>Sensitivity and Specificity</term><term>Thrombosis</term><term>Tomography, X-Ray Computed (methods)</term><term>Venous Thrombosis (diagnostic imaging)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Jambe</term><term>Lipodystrophie (imagerie diagnostique)</term><term>Lymphoedème (imagerie diagnostique)</term><term>Mâle</term><term>Sensibilité et spécificité</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Thrombose veineuse (imagerie diagnostique)</term><term>Tomodensitométrie ()</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lipodystrophy</term><term>Lymphedema</term><term>Venous Thrombosis</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lipodystrophie</term><term>Lymphoedème</term><term>Thrombose veineuse</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Leg</term><term>Male</term><term>Middle Aged</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Diagnostic différentiel</term><term>Femelle</term><term>Humains</term><term>Jambe</term><term>Lymphoedème</term><term>Mâle</term><term>Sensibilité et spécificité</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Thrombose</term><term>Tomodensitométrie</term><term>Veine profonde</term><term>Lipodystrophie</term><term>Oedème</term><term>Membre inférieur</term><term>Tomodensitométrie</term><term>Haute résolution</term><term>Diagnostic différentiel</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: To evaluate the accuracy of computed tomography (CT) scan imaging in distinguishing lymphedema from deep venous thrombosis (DVT) and lipodystrophy (lipedema) in patients with swollen legs. Material and Methods: CT scans of the lower limbs were performed in 55 patients with 76 swollen legs (44 lymph edemas, 12 DVT and 20 lipedemas). Thirty-four normal contralateral legs were also similarly evaluated. Primary lymphedema was verified by lymphography or lymphoscintigraphy, whereas secondary lymphedema was documented by a typical clinical history. DVT was established by ultrasound Doppler imaging. The diagnosis of lipedema was made with bilateral swollen legs where lymphoscintigraphy and Doppler examination were both unremarkable. Qualitative CT analysis was based on skin thickening, subcutaneous edema accumulation with a honeycombed pattern, and muscle compartment enlargement. Results: Sensitivity and specificity of CT scan for the diagnosis of lymph edema was 93 and 100%, respectively; for lipedema it was 95 and 100%, respectively; and for DVT it was 91 and 99%, respectively. Skin thickening was found in 42 lymphedemas (95%), in 9 DVT (75%), and in 2 lipedemas (16%). Subcutaneous edema accumulation was demonstrated in 42 legs (95%) with lymphedema and in 5 (42%) with DVT but in none with lipedema. A honeycombed pattern was present only in lymph edema (18 legs or 41%); muscle enlargement was present in all patients with DVT, in no patient with lipedema, and in 4 (9%) with lymph edema. Conclusion: Edema accumulation is readily demonstrated with plain CT scan and is not present in lipedema. Specific CT features of the subcutaneous fat and muscle compartments allow accurate differentiation between lymphedema and DVT.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Languedoc-Roussillon</li><li>Occitanie (région administrative)</li></region><settlement><li>Montpellier</li></settlement></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Monnin Delhom, E D" sort="Monnin Delhom, E D" uniqKey="Monnin Delhom E" first="E. D." last="Monnin-Delhom">E. D. Monnin-Delhom</name></region><name sortKey="Achard, C" sort="Achard, C" uniqKey="Achard C" first="C." last="Achard">C. Achard</name><name sortKey="Bruel, J M" sort="Bruel, J M" uniqKey="Bruel J" first="J. M." last="Bruel">J. M. Bruel</name><name sortKey="Gallix, B P" sort="Gallix, B P" uniqKey="Gallix B" first="B. P." last="Gallix">B. P. Gallix</name><name sortKey="Janbon, C" sort="Janbon, C" uniqKey="Janbon C" first="C." last="Janbon">C. Janbon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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