The Lymphatic Drainage Pattern of Internal Mammary Sentinel Lymph Node Identified by Small Particle Radiotracer (99mTc-Dextran 40) in Breast.
The Lymphatic Drainage Pattern of Internal Mammary Sentinel Lymph Node Identified by Small Particle Radiotracer (99mTc-Dextran 40) in Breast.
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小颗粒放射性示踪剂（99mTc-Dextran 40）识别乳腺内乳前哨淋巴结的淋巴引流模式
DOI：
10.4143/crt.2018.062
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发表时间：
2019-04
影响因子：
4.6
通讯作者：
Wang YS
中科院分区：
文献类型：
--
作者：
Cao XS;Yang GR;Cong BB;Qiu PF;Wang YS
目的本研究旨在检测内乳区淋巴引流模式，验证乳腺内乳前哨淋巴结（IM-SLN）的概念。材料和方法制备并测试了小颗粒放射性示踪剂（99mTc-Dextran 40）。通过改良的放射性示踪剂注射技术将 99mTc-Dextran 40 注射到健全乳房的实质内。随后，进行动态单光子发射计算机断层扫描（SPECT）、计算机断层扫描（CT）和SPECT/CT组合图像来识别放射性淋巴管和内乳淋巴结（IMLN）。在 SPECT/CT 成像中确定了淋巴引流方向和 IMLN 的位置。结果99mTc-Dextran 40放射化学纯度>95%。动物实验中99mTc-Dextran 40可引流至第一、第二、第三淋巴结，且放射性淋巴结可被γ探测器检测到。脑实质内注射99mTc-Dextran 40后，SPECT可识别出50.0%（15/30）的引流淋巴管和放射性IMLN。注射放射性示踪剂10.5±0.35分钟后，发现从注射点到第一个IMLN（IM-SLN）的引流淋巴管，然后99mTc-Dextran 40积累到IM-SLN中。 SPECT/CT 联合成像显示第二个 IMLN 接受来自 IM-SLN 的淋巴引流。淋巴引流是在内乳区逐步进行的。结论 淋巴液从乳腺不同区域引流至IM-SLN，然后从IM-SLN向外连续引流至其他IMLN。论证了IM-SLN的概念，为内乳前哨淋巴结活检的应用提供更多依据。
Purpose The purpose of this study was to detect the lymphatic drainage pattern of internal mammary area and verify the concept of internal mammary sentinel lymph node (IM-SLN) in breast. Materials and Methods A small particle radiotracer (99mTc-Dextran 40) was prepared and tested. 99mTc-Dextran 40 was injected into intraparenchyma at the sound breast by a modified radiotracer injection technique. Subsequently, dynamic single-photon emission computed tomography (SPECT), computed tomography (CT), and SPECT/CT combination images were performed to identify the radioactive lymph vessels and internal mammary lymph nodes (IMLNs). The direction of lymph drainage and the location of the IMLNs were identified in the SPECT/CT imaging. Results The radiochemical purity of 99mTc-Dextran 40 was > 95%. 99mTc-Dextran 40 could drainage into first, second, and third lymph node and the radioactive lymph node could be detected by the γ detector in the animal experiment. After 99mTc-Dextran 40 injecting into intraparenchyma, 50.0% cases (15/30) were identified the drainage lymphatic vessels and radioactive IMLNs by SPECT. The drainage lymphatic vessel was found from injection point to the first IMLN (IM-SLN) after 10.5±0.35 minutes radiotracer injection, and then 99mTc-Dextran 40 was accumulated into the IM-SLN. The combination imaging of SPECT/CT showed the second IMLN received the lymph drainage from the IM-SLN. The lymphatic drainage was step by step in the internal mammary area. Conclusion The lymph was identified to drain from different regions of the breast to IM-SLN, and then outward from IM-SLN to other IMLN consecutively. It demonstrated the concept of the IM-SLN and provided more evidences for the application of internal mammary sentinel lymph node biopsy.
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影响因子：
3.7
作者：
Suami, Hiroo;Pan, Wei-Ren;Taylor, G. Ian
通讯作者：
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影响因子：
2.2
作者：
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影响因子：
3.7
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Winchester, David J.
影响因子：
45.3
作者：
Thorsen, Lise Bech Jellesmark;Offersen, Birgitte Vrou;Overgaard, Jens
通讯作者：
Overgaard, Jens
影响因子：
8.4
作者：
Veronesi, U;Marubini, E;Zucali, R
通讯作者：
Zucali, R