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Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy

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Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy

Auteurs : Kotaro Suehiro [Japon] ; Noriyasu Morikage [Japon] ; Masanori Murakami [Japon] ; Osamu Yamashita [Japon] ; Takasuke Harada [Japon] ; Koshiro Ueda [Japon] ; Makoto Samura [Japon] ; Yuya Tanaka [Japon] ; Kimikazu Hamano [Japon]

Source :

Annals of Vascular Diseases [ 1881-641X ] ; 2015.

RBID : PMC:4485042

Abstract

Purpose: To use qualitative lymphangioscintigraphy (LAS) findings to differentiate leg edema caused by high and low output lymphatic failure.

Methods: LAS was performed in legs with secondary lymphedema (LE), i.e., low output failure (N = 79), and functional venous insufficiency (FVI), i.e., high output failure (N = 56), and normal legs (N = 26). Whole body images were obtained, 15, 60, and 180 min after technetium-99m injection. The rate and timing of visualization of lymphatic structures, washout out of tracer, and presence of dermal backflow were assessed.

Results: The most significant finding for differentiating LE from other conditions was not the visualization of lymphatic structures, but the washout of the tracer from the leg trunk (LE 27%, FVI 100%, normal leg 100%, P <.0001). On the other hand, the most significant finding for differentiating FVI from other legs was the visualization of inguinal lymph nodes at 15 min (LE 11%, FVI 82%, normal leg 8%, P <.0001).

Conclusions: We found that the lack of washout from the leg trunk was most suggestive of a low output status of the lymphatic system, while earlier visualization of inguinal lymph nodes was suggestive of a high output status.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485042

DOI: 10.3400/avd.oa.15-00034
PubMed: 26131028
PubMed Central: 4485042

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<author><name sortKey="Samura, Makoto" sort="Samura, Makoto" uniqKey="Samura M" first="Makoto" last="Samura">Makoto Samura</name>
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<front><div type="abstract" xml:lang="en"><p>Purpose: To use qualitative lymphangioscintigraphy (LAS) findings to differentiate leg edema caused by high and low output lymphatic failure.</p>
<p>Methods: LAS was performed in legs with secondary lymphedema (LE), i.e., low output failure (N = 79), and functional venous insufficiency (FVI), i.e., high output failure (N = 56), and normal legs (N = 26). Whole body images were obtained, 15, 60, and 180 min after technetium-99m injection. The rate and timing of visualization of lymphatic structures, washout out of tracer, and presence of dermal backflow were assessed.</p>
<p>Results: The most significant finding for differentiating LE from other conditions was not the visualization of lymphatic structures, but the washout of the tracer from the leg trunk (LE 27%, FVI 100%, normal leg 100%, <italic>P</italic>
 <.0001). On the other hand, the most significant finding for differentiating FVI from other legs was the visualization of inguinal lymph nodes at 15 min (LE 11%, FVI 82%, normal leg 8%, <italic>P</italic>
 <.0001).</p>
<p>Conclusions: We found that the lack of washout from the leg trunk was most suggestive of a low output status of the lymphatic system, while earlier visualization of inguinal lymph nodes was suggestive of a high output status.</p>
</div>
</front>
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Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy

Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy

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Abstract

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