MR Lymphography of Lymphatic Vessels in Lower Extremity with Gynecologic Oncology-Related Lymphedema
Identifieur interne : 002909 ( Pmc/Checkpoint ); précédent : 002908; suivant : 002910MR Lymphography of Lymphatic Vessels in Lower Extremity with Gynecologic Oncology-Related Lymphedema
Auteurs : Qing Lu [République populaire de Chine] ; Zachary Delproposto [États-Unis] ; Alice Hu [États-Unis] ; Christine Tran [États-Unis] ; Ningfei Liu [République populaire de Chine] ; Yulai Li [République populaire de Chine] ; Jianrong Xu [République populaire de Chine] ; Duy Bui [États-Unis] ; Jiani Hu [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
To characterize lymphatic vessel morphology in lower extremity lymphedema using MR lymphography at 3T.
Forty females with lower extremity lymphedema secondary to gynecologic carcinoma treatment underwent MR lymphography (MRL) at 3T. Lymphatic vessel morphology in normal and affected limbs was compared.
The median diameter of the lymphatic vessels in swollen calf and thigh were significantly larger than that in the contralateral calf and thigh, respectively (p<0.05). The median number of lymphatic vessels visualized in normal calf was less than that in the lymphedematous calf (p<0.01), while no significant difference was found between the normal thigh and swollen thigh. Lymphatic vessel number in the affected calf was significantly greater than that in affected thigh and the mean diameter of affected calf was also significantly wider than that of affected thigh (p<0.01). Mean diameter of lymphatic vessels in the affected calf was significantly different between stage I and stage III (p<0.05), but not significantly different between stages I and II, and between stages II and III (p>0.05). The median number of lymphatic vessels for affected calf showed significant difference between stage I and stage III, and between stage II and stage III (p<0.05), but no significant difference between stage I and stage II (p>0.05). There was no significant difference in mean diameter or median number of lymphatic vessels in the affected thigh found between different stages (p>0.05).
There are significant differences in the number or diameter of lymphatic vessels between normal and affected limbs and there are significant differences for affected calf between early and late stages of lymphedema; therefore, MR lymphography can be helpful in diagnosis or clinical staging for lower extremity with gynecologic oncology-related lymphedema.
Url:
DOI: 10.1371/journal.pone.0050319
PubMed: 23209708
PubMed Central: 3509000
Affiliations:
- République populaire de Chine, États-Unis
- Michigan, New Jersey
- East Lansing
- Université d'État du Michigan
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Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Henry Ford Hospital, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Hu, Alice" sort="Hu, Alice" uniqKey="Hu A" first="Alice" last="Hu">Alice Hu</name><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Natural Sciences, Michigan State University, East Lansing, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Natural Sciences, Michigan State University, East Lansing, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Tran, Christine" sort="Tran, Christine" uniqKey="Tran C" first="Christine" last="Tran">Christine Tran</name><affiliation wicri:level="2"><nlm:aff id="aff4"><addr-line>Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey</wicri:regionArea><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Liu, Ningfei" sort="Liu, Ningfei" uniqKey="Liu N" first="Ningfei" last="Liu">Ningfei Liu</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Department of Plastic & Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of 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id="aff6"><addr-line>Department of Radiology, Wayne State University, Detroit, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Wayne State University, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23209708</idno><idno type="pmc">3509000</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509000</idno><idno type="RBID">PMC:3509000</idno><idno type="doi">10.1371/journal.pone.0050319</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">004456</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004456</idno><idno type="wicri:Area/Pmc/Curation">004455</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004455</idno><idno 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last="Delproposto">Zachary Delproposto</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Department of Radiology, Henry Ford Hospital, Detroit, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Henry Ford Hospital, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Hu, Alice" sort="Hu, Alice" uniqKey="Hu A" first="Alice" last="Hu">Alice Hu</name><affiliation wicri:level="4"><nlm:aff id="aff3"><addr-line>Department of Natural Sciences, Michigan State University, East Lansing, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Natural Sciences, Michigan State University, East Lansing, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Tran, Christine" sort="Tran, Christine" uniqKey="Tran C" first="Christine" last="Tran">Christine Tran</name><affiliation wicri:level="2"><nlm:aff id="aff4"><addr-line>Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey</wicri:regionArea><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Liu, Ningfei" sort="Liu, Ningfei" uniqKey="Liu N" first="Ningfei" last="Liu">Ningfei Liu</name><affiliation wicri:level="1"><nlm:aff id="aff5"><addr-line>Department of Plastic & Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Plastic & Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Li, Yulai" sort="Li, Yulai" uniqKey="Li Y" first="Yulai" last="Li">Yulai Li</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Jianrong" sort="Xu, Jianrong" uniqKey="Xu J" first="Jianrong" last="Xu">Jianrong Xu</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Bui, Duy" sort="Bui, Duy" uniqKey="Bui D" first="Duy" last="Bui">Duy Bui</name><affiliation wicri:level="2"><nlm:aff id="aff6"><addr-line>Department of Radiology, Wayne State University, Detroit, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Wayne State University, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Hu, Jiani" sort="Hu, Jiani" uniqKey="Hu J" first="Jiani" last="Hu">Jiani Hu</name><affiliation wicri:level="2"><nlm:aff id="aff6"><addr-line>Department of Radiology, Wayne State University, Detroit, Michigan, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiology, Wayne State University, Detroit, Michigan</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>To characterize lymphatic vessel morphology in lower extremity lymphedema using MR lymphography at 3T.</p></sec><sec><title>Study Design</title><p>Forty females with lower extremity lymphedema secondary to gynecologic carcinoma treatment underwent MR lymphography (MRL) at 3T. Lymphatic vessel morphology in normal and affected limbs was compared.</p></sec><sec><title>Results</title><p>The median diameter of the lymphatic vessels in swollen calf and thigh were significantly larger than that in the contralateral calf and thigh, respectively (p<0.05). The median number of lymphatic vessels visualized in normal calf was less than that in the lymphedematous calf (p<0.01), while no significant difference was found between the normal thigh and swollen thigh. Lymphatic vessel number in the affected calf was significantly greater than that in affected thigh and the mean diameter of affected calf was also significantly wider than that of affected thigh (p<0.01). Mean diameter of lymphatic vessels in the affected calf was significantly different between stage I and stage III (p<0.05), but not significantly different between stages I and II, and between stages II and III (p>0.05). The median number of lymphatic vessels for affected calf showed significant difference between stage I and stage III, and between stage II and stage III (p<0.05), but no significant difference between stage I and stage II (p>0.05). There was no significant difference in mean diameter or median number of lymphatic vessels in the affected thigh found between different stages (p>0.05).</p></sec><sec><title>Conclusion</title><p>There are significant differences in the number or diameter of lymphatic vessels between normal and affected limbs and there are significant differences for affected calf between early and late stages of lymphedema; therefore, MR lymphography can be helpful in diagnosis or clinical staging for lower extremity with gynecologic oncology-related lymphedema.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lockwood Rayermann, S" uniqKey="Lockwood Rayermann S">S Lockwood-Rayermann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kashima, K" uniqKey="Kashima K">K Kashima</name></author><author><name sortKey="Yahata, T" uniqKey="Yahata T">T Yahata</name></author><author><name sortKey="Fujita, K" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23209708</article-id><article-id pub-id-type="pmc">3509000</article-id><article-id pub-id-type="publisher-id">PONE-D-12-21533</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0050319</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Anatomy and Physiology</subject><subj-group><subject>Immune Physiology</subject><subj-group><subject>Lymphatic System</subject></subj-group></subj-group></subj-group><subj-group><subject>Cardiovascular</subject><subj-group><subject>Valvular Disease</subject></subj-group></subj-group><subj-group><subject>Obstetrics and Gynecology</subject><subj-group><subject>Gynecologic Cancers</subject></subj-group></subj-group><subj-group><subject>Oncology</subject><subj-group><subject>Cancers and Neoplasms</subject><subj-group><subject>Gynecological Tumors</subject></subj-group></subj-group></subj-group><subj-group><subject>Radiology</subject><subj-group><subject>Diagnostic Radiology</subject><subj-group><subject>Magnetic Resonance Imaging</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>MR Lymphography of Lymphatic Vessels in Lower Extremity with Gynecologic Oncology-Related Lymphedema</article-title><alt-title alt-title-type="running-head">MR Lymphography in Lower Extremity Lymphedema</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Lu</surname><given-names>Qing</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Delproposto</surname><given-names>Zachary</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hu</surname><given-names>Alice</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Tran</surname><given-names>Christine</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Liu</surname><given-names>Ningfei</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>Yulai</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Xu</surname><given-names>Jianrong</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bui</surname><given-names>Duy</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Hu</surname><given-names>Jiani</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Department of Radiology, Henry Ford Hospital, Detroit, Michigan, United States of America</addr-line></aff><aff id="aff3"><label>3</label><addr-line>Department of Natural Sciences, Michigan State University, East Lansing, Michigan, United States of America</addr-line></aff><aff id="aff4"><label>4</label><addr-line>Graduate School of Biomedical Sciences, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, United States of America</addr-line></aff><aff id="aff5"><label>5</label><addr-line>Department of Plastic & Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China</addr-line></aff><aff id="aff6"><label>6</label><addr-line>Department of Radiology, Wayne State University, Detroit, Michigan, United States of America</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Chen</surname><given-names>Xiaoyuan</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>NIH, United States of America</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>xujian_renji@163.com</email> (JX); <email>jhu@med.wayne.edu</email> (JH)</corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: QL JX JH. Performed the experiments: QL NL YL. Analyzed the data: YL QL. Contributed reagents/materials/analysis tools: YL DB CT AH. Wrote the paper: ZD CT DB AH JH.</p></fn></author-notes><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>28</day><month>11</month><year>2012</year></pub-date><volume>7</volume><issue>11</issue><elocation-id>e50319</elocation-id><history><date date-type="received"><day>19</day><month>7</month><year>2012</year></date><date date-type="accepted"><day>18</day><month>10</month><year>2012</year></date></history><permissions><copyright-year>2012</copyright-year><copyright-holder>Lu et al</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><sec><title>Objective</title><p>To characterize lymphatic vessel morphology in lower extremity lymphedema using MR lymphography at 3T.</p></sec><sec><title>Study Design</title><p>Forty females with lower extremity lymphedema secondary to gynecologic carcinoma treatment underwent MR lymphography (MRL) at 3T. Lymphatic vessel morphology in normal and affected limbs was compared.</p></sec><sec><title>Results</title><p>The median diameter of the lymphatic vessels in swollen calf and thigh were significantly larger than that in the contralateral calf and thigh, respectively (p<0.05). The median number of lymphatic vessels visualized in normal calf was less than that in the lymphedematous calf (p<0.01), while no significant difference was found between the normal thigh and swollen thigh. Lymphatic vessel number in the affected calf was significantly greater than that in affected thigh and the mean diameter of affected calf was also significantly wider than that of affected thigh (p<0.01). Mean diameter of lymphatic vessels in the affected calf was significantly different between stage I and stage III (p<0.05), but not significantly different between stages I and II, and between stages II and III (p>0.05). The median number of lymphatic vessels for affected calf showed significant difference between stage I and stage III, and between stage II and stage III (p<0.05), but no significant difference between stage I and stage II (p>0.05). There was no significant difference in mean diameter or median number of lymphatic vessels in the affected thigh found between different stages (p>0.05).</p></sec><sec><title>Conclusion</title><p>There are significant differences in the number or diameter of lymphatic vessels between normal and affected limbs and there are significant differences for affected calf between early and late stages of lymphedema; therefore, MR lymphography can be helpful in diagnosis or clinical staging for lower extremity with gynecologic oncology-related lymphedema.</p></sec></abstract><funding-group><funding-statement>This work was supported by National Natural Science Foundation of China (81271638, 30970819); National Basic Research Program of China (973 Program, 2012CB932600); Shanghai Leading Academic Discipline Project (S30203); and the Doctor Innovation Fund (BXJ201118)) from Shanghai Jiaotong University School of Medicine. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><page-count count="6"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Michigan</li><li>New Jersey</li></region><settlement><li>East Lansing</li></settlement><orgName><li>Université d'État du Michigan</li></orgName></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Lu, Qing" sort="Lu, Qing" uniqKey="Lu Q" first="Qing" last="Lu">Qing Lu</name></noRegion><name sortKey="Li, Yulai" sort="Li, Yulai" uniqKey="Li Y" first="Yulai" last="Li">Yulai Li</name><name sortKey="Liu, Ningfei" sort="Liu, Ningfei" uniqKey="Liu N" first="Ningfei" last="Liu">Ningfei Liu</name><name sortKey="Xu, Jianrong" sort="Xu, Jianrong" uniqKey="Xu J" first="Jianrong" last="Xu">Jianrong Xu</name></country><country name="États-Unis"><region name="Michigan"><name sortKey="Delproposto, Zachary" sort="Delproposto, Zachary" uniqKey="Delproposto Z" first="Zachary" last="Delproposto">Zachary Delproposto</name></region><name sortKey="Bui, Duy" sort="Bui, Duy" uniqKey="Bui D" first="Duy" last="Bui">Duy Bui</name><name sortKey="Hu, Alice" sort="Hu, Alice" uniqKey="Hu A" first="Alice" last="Hu">Alice Hu</name><name sortKey="Hu, Jiani" sort="Hu, Jiani" uniqKey="Hu J" first="Jiani" last="Hu">Jiani Hu</name><name sortKey="Tran, Christine" sort="Tran, Christine" uniqKey="Tran C" first="Christine" last="Tran">Christine Tran</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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