Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy
Identifieur interne : 002C38 ( Pmc/Corpus ); précédent : 002C37; suivant : 002C39Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy
Auteurs : Kotaro Suehiro ; Noriyasu Morikage ; Masanori Murakami ; Osamu Yamashita ; Takasuke Harada ; Koshiro Ueda ; Makoto Samura ; Yuya Tanaka ; Kimikazu HamanoSource :
- Annals of Vascular Diseases [ 1881-641X ] ; 2015.
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%,
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:
DOI: 10.3400/avd.oa.15-00034
PubMed: 26131028
PubMed Central: 4485042
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PMC:4485042Le document en format XML
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<author><name sortKey="Suehiro, Kotaro" sort="Suehiro, Kotaro" uniqKey="Suehiro K" first="Kotaro" last="Suehiro">Kotaro Suehiro</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Morikage, Noriyasu" sort="Morikage, Noriyasu" uniqKey="Morikage N" first="Noriyasu" last="Morikage">Noriyasu Morikage</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Murakami, Masanori" sort="Murakami, Masanori" uniqKey="Murakami M" first="Masanori" last="Murakami">Masanori Murakami</name>
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<author><name sortKey="Yamashita, Osamu" sort="Yamashita, Osamu" uniqKey="Yamashita O" first="Osamu" last="Yamashita">Osamu Yamashita</name>
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<author><name sortKey="Harada, Takasuke" sort="Harada, Takasuke" uniqKey="Harada T" first="Takasuke" last="Harada">Takasuke Harada</name>
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<author><name sortKey="Ueda, Koshiro" sort="Ueda, Koshiro" uniqKey="Ueda K" first="Koshiro" last="Ueda">Koshiro Ueda</name>
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<author><name sortKey="Tanaka, Yuya" sort="Tanaka, Yuya" uniqKey="Tanaka Y" first="Yuya" last="Tanaka">Yuya Tanaka</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Hamano, Kimikazu" sort="Hamano, Kimikazu" uniqKey="Hamano K" first="Kimikazu" last="Hamano">Kimikazu Hamano</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Suehiro, Kotaro" sort="Suehiro, Kotaro" uniqKey="Suehiro K" first="Kotaro" last="Suehiro">Kotaro Suehiro</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
</affiliation>
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<author><name sortKey="Morikage, Noriyasu" sort="Morikage, Noriyasu" uniqKey="Morikage N" first="Noriyasu" last="Morikage">Noriyasu Morikage</name>
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<author><name sortKey="Murakami, Masanori" sort="Murakami, Masanori" uniqKey="Murakami M" first="Masanori" last="Murakami">Masanori Murakami</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Yamashita, Osamu" sort="Yamashita, Osamu" uniqKey="Yamashita O" first="Osamu" last="Yamashita">Osamu Yamashita</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
</affiliation>
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<author><name sortKey="Harada, Takasuke" sort="Harada, Takasuke" uniqKey="Harada T" first="Takasuke" last="Harada">Takasuke Harada</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
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<author><name sortKey="Ueda, Koshiro" sort="Ueda, Koshiro" uniqKey="Ueda K" first="Koshiro" last="Ueda">Koshiro Ueda</name>
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<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
</affiliation>
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<author><name sortKey="Tanaka, Yuya" sort="Tanaka, Yuya" uniqKey="Tanaka Y" first="Yuya" last="Tanaka">Yuya Tanaka</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
</affiliation>
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<author><name sortKey="Hamano, Kimikazu" sort="Hamano, Kimikazu" uniqKey="Hamano K" first="Kimikazu" last="Hamano">Kimikazu Hamano</name>
<affiliation><nlm:aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</nlm:aff>
</affiliation>
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<series><title level="j">Annals of Vascular Diseases</title>
<idno type="ISSN">1881-641X</idno>
<idno type="eISSN">1881-6428</idno>
<imprint><date when="2015">2015</date>
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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>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Vasc Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Ann Vasc Dis</journal-id>
<journal-id journal-id-type="pmc">avd</journal-id>
<journal-title-group><journal-title>Annals of Vascular Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">1881-641X</issn>
<issn pub-type="epub">1881-6428</issn>
<publisher><publisher-name>The Editorial Committee of Annals of Vascular Diseases</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26131028</article-id>
<article-id pub-id-type="pmc">4485042</article-id>
<article-id pub-id-type="publisher-id">avd.oa.15-00034</article-id>
<article-id pub-id-type="doi">10.3400/avd.oa.15-00034</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Differentiation of High and Low Output Lymphatic Failure Using Qualitative Lymphangioscintigraphy</article-title>
<alt-title alt-title-type="left-running-head">Suehiro K, et al.</alt-title>
<alt-title alt-title-type="right-running-head">Lymphangioscintigraphy in Various Leg Edema</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Suehiro</surname>
<given-names>Kotaro</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Morikage</surname>
<given-names>Noriyasu</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Murakami</surname>
<given-names>Masanori</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Yamashita</surname>
<given-names>Osamu</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Harada</surname>
<given-names>Takasuke</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ueda</surname>
<given-names>Koshiro</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Samura</surname>
<given-names>Makoto</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tanaka</surname>
<given-names>Yuya</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hamano</surname>
<given-names>Kimikazu</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"></xref>
</contrib>
<aff id="aff1">Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan</aff>
</contrib-group>
<author-notes><corresp>Corresponding author: Kotaro Suehiro, MD. Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505 Japan Tel: +81-836-22-2260, Fax: +81-836-22-2423</corresp>
<fn><p>E-mail: <email xlink:href="mailto:ksuehiro-circ@umin.ac.jp">ksuehiro-circ@umin.ac.jp</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>26</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><year>2015</year>
</pub-date>
<volume>8</volume>
<issue>2</issue>
<fpage>93</fpage>
<lpage>99</lpage>
<history><date date-type="received"><day>9</day>
<month>4</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>23</day>
<month>4</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Annals of Vascular Diseases 2015</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract><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>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>leg</kwd>
<kwd>lymphedema</kwd>
<kwd>venous insufficiency</kwd>
<kwd>lymphangioscintigraphy</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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