^(99)Tc^m-右旋糖酐淋巴显像评价Klippel-Trenaunay综合征淋巴管畸形及淋巴水肿

^(99)Tc^m-Dextran lymphoscintigraphy in evaluation on malformation of lymphatic vessels and lymphedema in Klippel-Trenaunay syndrome

目的观察^(99 )Tc^m-右旋糖酐(^(99 )Tc^m-DX)淋巴显像评价Klippel-Trenaunay综合征(KTS)患者淋巴管畸形及淋巴水肿的应用价值。方法回顾性分析36例临床确诊为KTS患者的临床及核素淋巴显像资料。经双足趾间皮下注射^(99 )Tc^m-DX后,分别于给药后10min、1h、3h及6h行全身淋巴显像,观察患者双下肢淋巴管、双腹股沟及髂、腰淋巴结、胸导管及静脉角区的显影情况以及全身其他部位有无显像剂异常分布。结果36例KTS患者中,35例淋巴显像提示淋巴管、淋巴结显影异常并伴淋巴水肿,其中31例为单侧下肢淋巴水肿、4例为双下肢淋巴水肿。20例出现颈部静脉角区域异常显影,其中15例为左静脉角区域显像剂滞留,2例为右静脉角区域显像剂滞留,3例为双静脉角区域显像剂滞留。12例伴会阴部淋巴水肿。8例出现身体其他部位的异常淋巴管显影。结论^(99 )Tc^m-DX淋巴显像可以评价KTS患者淋巴管与淋巴结发育异常以及胸导管回流状况。

Objective To investigate the application value of 99 Tc m-Dextran(DX)lymphoscintigraphy in patients with Klippel-Trenaunay syndrome(KTS).Methods 99 Tc m-DX lymphoscintigraphic appearances of 36 patients with clinically diagnosed KTS were retrospectively analyzed.All patients underwent whole-body lymphoscintigraphy 10 min,1 h,3 h and 6 h after injection of 99 Tc m-DX into the interdigital spaces of both feet.Lymphoscintigrams were studied for visualization of lymphatics,lymph nodes,thoracic duct,the region of jugular venous angle and other abnormalities.Results Lymphoscintigraphyic anomalies were found in 35 of 36 patients,including abnormal imaging of lymphatics,lymph nodes and lymphedema,among them affected unilateral lower limb was detected in 31 patients,while affected both limbs were observed in the other 4 patients.Local radiotracer focused on the jugular venous angle was shown in 20 patients,15 on left,2 on right and 3 on bilateral jugular venous angles.Radioactivities focused on the scrotal areas were observed in 12 patients,and dilated lymphatic vessels at other regions were noticed in 8 patients.Conclusion 99 Tc m-DX lymphoscintigraphy can show the malformation of lymphatic vessels,lymph nodes and lymphedema,as well as the malformation and obstruction of the thoracic duct in KTS patients.