Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema
Identifieur interne : 003155 ( Main/Exploration ); précédent : 003154; suivant : 003156Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema
Auteurs : Ahmed Abdel-Samie Kandeel [Égypte] ; Jehan Ahmed Younes [Égypte] ; Ahmed Mohamed Zaher [Égypte]Source :
- Indian Journal of Nuclear Medicine : IJNM : The Official Journal of the Society of Nuclear Medicine, India [ 0972-3919 ] ; 2013.
Abstract
To examine the frequency and significance of visualization of popliteal nodes during lymphoscintigraphy for the investigation of lower extremity swelling.
Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 90 patients (24 males, 66 females; age range, 4-70 years) who had clinical evidence of lower limb lymphedema and were referred for routine lymphoscintigraphy; imaging was performed 5, and 90 minutes after injection without any vigorous exercise between the injection and imaging.
According to the scan findings, patients were divided into two groups; group I included 63 patients without popliteal nodes visualization on scanning, and group II included 27 patients with positive popliteal nodes uptake. None of patients with primary lymphedema (
Popliteal lymph nodes uptake during lymphoscintigraphy for clinical lymphedema of the lower limb indicates lymph rerouting through the deep system and raises a diagnosis of higher severity and longer duration of lymphatic dysfunction.
Url:
DOI: 10.4103/0972-3919.119540
PubMed: 24250020
PubMed Central: 3822411
Affiliations:
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Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Nuclear Medicine, Kasr Al-Ainy Hospital (NEMROCK), Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Mohamed Zaher, Ahmed" sort="Mohamed Zaher, Ahmed" uniqKey="Mohamed Zaher A" first="Ahmed" last="Mohamed Zaher">Ahmed Mohamed Zaher</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24250020</idno><idno type="pmc">3822411</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822411</idno><idno type="RBID">PMC:3822411</idno><idno 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Medicine, Kasr Al-Ainy Hospital (NEMROCK), Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Ahmed Younes, Jehan" sort="Ahmed Younes, Jehan" uniqKey="Ahmed Younes J" first="Jehan" last="Ahmed Younes">Jehan Ahmed Younes</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Nuclear Medicine, Kasr Al-Ainy Hospital (NEMROCK), Cairo, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Nuclear Medicine, Kasr Al-Ainy Hospital (NEMROCK), Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author><author><name sortKey="Mohamed Zaher, Ahmed" sort="Mohamed Zaher, Ahmed" uniqKey="Mohamed Zaher A" first="Ahmed" last="Mohamed Zaher">Ahmed Mohamed Zaher</name><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt</nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea>Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo</wicri:regionArea><wicri:noRegion>Cairo</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian Journal of Nuclear Medicine : IJNM : The Official Journal of the Society of Nuclear Medicine, India</title><idno type="ISSN">0972-3919</idno><idno type="eISSN">0974-0244</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Purpose:</title><p>To examine the frequency and significance of visualization of popliteal nodes during lymphoscintigraphy for the investigation of lower extremity swelling.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 90 patients (24 males, 66 females; age range, 4-70 years) who had clinical evidence of lower limb lymphedema and were referred for routine lymphoscintigraphy; imaging was performed 5, and 90 minutes after injection without any vigorous exercise between the injection and imaging.</p></sec><sec id="st3"><title>Results:</title><p>According to the scan findings, patients were divided into two groups; group I included 63 patients without popliteal nodes visualization on scanning, and group II included 27 patients with positive popliteal nodes uptake. None of patients with primary lymphedema (<italic>N</italic> = 22) due to agenesis or hypoplasia showed popliteal node uptake, whereas, patients with secondary lymphedema (<italic>N</italic> = 68) had either severe (<italic>N</italic> = 23) or partial (<italic>N</italic> = 45) lymphatic obstruction. A high positive association of popliteal node uptake with the severity of lymphatic obstruction was noted. Popliteal nodes were visualized in 26 of 57 patients with dermal back flow (46%), and in only 1 of 33 patients without dermal back flow (3%). There was a strong association between skin rerouting and popliteal node visualization (<italic>P</italic> < 0.01). Skin changes were detected in 24 patients (38%) with positive popliteal node uptake.</p></sec><sec id="st4"><title>Conclusion:</title><p>Popliteal lymph nodes uptake during lymphoscintigraphy for clinical lymphedema of the lower limb indicates lymph rerouting through the deep system and raises a diagnosis of higher severity and longer duration of lymphatic dysfunction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mortimer, Ps" uniqKey="Mortimer P">PS Mortimer</name></author><author><name sortKey="Levick, Jr" uniqKey="Levick J">JR Levick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Clarke, D" uniqKey="Clarke D">D Clarke</name></author><author><name sortKey="Martinez, A" uniqKey="Martinez A">A Martinez</name></author><author><name sortKey="Cox, Rs" uniqKey="Cox R">RS Cox</name></author><author><name sortKey="Goffinet, Dr" uniqKey="Goffinet D">DR 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