核素淋巴造影和动态磁共振淋巴造影诊断肢体淋巴水肿的比较研究

Comparison study of radionuclide iymphoscintigraphy and dynamic magnetic resonance lymphangiography for the diagnosis of extremity lymphedema

目的 比较核素淋巴造影与磁共振淋巴造影对肢体淋巴水肿的诊断作用.方法 18例肢体淋巴水肿患者分别接受了^99Tc-标记的右旋糖酐为造影剂的核素淋巴造影和钆贝葡胺为显影剂的核磁共振淋巴造影检查,从淋巴系统的形态和功能显像结果对2种方法进行了比较.结果 18例中磁共振淋巴造影清晰显示14例患肢的淋巴管,核素淋巴造影只显示1例.磁共振淋巴造影显示16例患肢的腹股沟淋巴结,核索淋巴造影只显示9例.磁共振淋巴造影通过对造影剂的实时追踪能够提供详尽的淋巴系统病变信息.结论 动态磁共振淋巴造影能够更精确和敏感地检测淋巴水肿肢体的淋巴管、淋巴结结构和功能的病变.

Objective To compare the role of radionuclide lymphoscintigraphy and dynamic magnetic resonance lymphangiography （ MRL） for the diagnosis of extremity lymphedema. Methods Sixteen patients with primary extremity lymphedema and two with Klippel-Trenaunay syndrome combined with lymphedema were examined by lymphoscintigraphy using the tracer ^99Tc-labelled dextran, and also by MRL using gadobenate dimeglumine as contrast agent. The results of morphological abnormalities and functional state of the lymphatic system at affected limbs from the two imaging methods were compared. Results Lymphatic vessels were imaged in 14 of 18 limbs with lymphedema using MRL, compared with one of 18 using lymphscintigraphy. MRL detected the inguinal nodes in 16 of 17 patients, whereas lymphscintigraphy revealed inguinal nodes in only nine cases. MRL revealed more precise information about structural and functional abnormalities of lymph vessels and nodes than lymphoscintigraphy by real-time measurement of lymph flow in vessels and nodes. Conclusions Dynamic MRL is more sensitive and accurate than lymphoscintigraphy in the detection of anatomical and functional abnormalities in the lymphatic system in patients with extremity lymphedema.