Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper Limbs
Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper Limbs
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DOI：
10.1371/journal.pone.0038182
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发表时间：
2012-06-04
期刊：
影响因子：
3.7
通讯作者：
Koshima, Isao
中科院分区：
文献类型：
--
作者：
Mihara, Makoto;Hara, Hisako;Koshima, Isao
背景：癌症治疗中淋巴结清扫后，由于淋巴滞留，继发性水肿会导致肢体肿胀。在出现水肿后立即开始治疗是非常重要的，但没有早期诊断水肿的方法。在这项研究中，我们比较了四种诊断成像方法的效用：磁共振成像（MRI），计算机断层扫描（CT），淋巴管造影，吲哚菁绿色（ICG）lymphography.Patients和方法：2010年4月至2011年11月，我们检查了21例女性患者（42臂）单侧轻度上肢水肿使用的四种方法。患者平均年龄为60.4岁（35-81岁）。结果：4种方法的特异性均为1。ICG淋巴造影和MRI的敏感性为1，淋巴造影为0.62，CT为0.33。结果表明，MRI和ICG淋巴造影对水肿的诊断上级淋巴管造影和CT。在某些病例中，活检结果提示皮肤和淋巴管异常，而淋巴管造影未显示异常结果。ICG淋巴造影显示，在这些cases.Conclusions真皮回流模式：我们的研究结果表明，双重诊断的重要性，通过检查淋巴系统ICG淋巴造影和评价水肿，在皮下脂肪组织使用MRI。
Background: Secondary lymphedema causes swelling in limbs due to lymph retention following lymph node dissection in cancer therapy. Initiation of treatment soon after appearance of edema is very important, but there is no method for early diagnosis of lymphedema. In this study, we compared the utility of four diagnostic imaging methods: magnetic resonance imaging (MRI), computed tomography (CT), lymphoscintigraphy, and Indocyanine Green (ICG) lymphography.Patients and Methods: Between April 2010 and November 2011, we examined 21 female patients (42 arms) with unilateral mild upper limb lymphedema using the four methods. The mean age of the patients was 60.4 years old (35-81 years old). Biopsies of skin and collecting lymphatic vessels were performed in 7 patients who underwent lymphaticovenous anastomosis.Results: The specificity was 1 for all four methods. The sensitivity was 1 in ICG lymphography and MRI, 0.62 in lymphoscintigraphy, and 0.33 in CT. These results show that MRI and ICG lymphography are superior to lymphoscintigraphy or CT for diagnosis of lymphedema. In some cases, biopsy findings suggested abnormalities in skin and lymphatic vessels for which lymphoscintigraphy showed no abnormal findings. ICG lymphography showed a dermal backflow pattern in these cases.Conclusions: Our findings suggest the importance of dual diagnosis by examination of the lymphatic system using ICG lymphography and evaluation of edema in subcutaneous fat tissue using MRI.