Noncontrast three-dimensional magnetic resonance imaging vs lymphoscintigraphy in the evaluation of lymph circulation disorders: A comparative study

Liu, Ningfei; Wang, Chenguang; Minghua, Sun

doi:10.1016/j.jvs.2004.11.013

Cited by 67 publications

(48 citation statements)

References 1 publication

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“…Newer technologies including three-dimensional magnetic resonance imaging (MRI) (18), lymphoscintigraphy, computerized tomography (CT), ultrasound (19) and bioelectrical impedance analysis are reserved for patients with bilateral lymphedema without a definitive diagnosis or in cases where a lymphatic obstruction is suspected for malignancy. Lymphoscintigraphy is not commonly used, due to the lack of standardized protocol in performing the test.…”

Section: Diagnosismentioning

confidence: 99%

Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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Section: Diagnosismentioning

confidence: 99%

Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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“…Among the imaging modalities, cystourethroscopy, lymphangiography, lymphoscintigraphy,[10] MRI abdomen and retrograde pyelography can be employed to find out the site of leakage of lymph. MRI appears to be an easily available non-invasive modality that delineates the dilated lymphatic clusters as multiple tortuous fluid filled channels.…”

Section: Discussionmentioning

confidence: 99%

Analysis of case series of milky urine: A single center and departmental clinical experience with emphasis on management perspectives: A prospective observational study

et al. 2014

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Background:Milky urine can be due to chyluria or lipiduria due to nephrotic syndrome. Filarial chyluria usually responds to medical management while non-filarial cases may require surgical intervention.Aim:To perform a prospective observational study in patients presenting with milky urine in our centre over a period of one year from July 2011 to June 2012, a complete biochemical work up and imaging to find out the site of leakage of lymph if it is a case of chyluria, its response to medical management and the requirement of surgical intervention.Materials and Methods:Routine blood and urine investigations, 24 hour urine protein excretion, USG abdomen, serum lipid profile and rapid filarial antigen test were done in all. MRI abdomen was done in affordable patients. Renal biopsy was done in some chyluria patients for academic purpose and in milky urine with negative urine ether test. Sclerotherapy was done with 50% dextrose and 0.2% povidone iodine. Patients were followed up with 24 hour urine protein and triglyceride estimation.Results:18 cases of milky urine were encountered. 8 were filarial chyluria, 9 non- filarial and 1 MCD. Mean urine TG level and median 24 hour urinary protein excretion were 37.2 ± 24.6 mg% and 4.96 g respectively. The mean age for filariasis (22.9 ± 4.5 years) was significantly different from that of non-filarial etiology (31.5 ± 4.8 years) (P = 0.005). The mean 24 hour urinary protein for normal MRI cases (4.64 ± 0.70 g) was significantly different from those with dilated lymphatics (8.15 ± 2.55 g) (P = 0.02). All the non- filarial and 4 filarial cases required sclerotherapy. One patient required a second sitting.Conclusion:Milky urine is most commonly due to chyluria and occasionally due to nephrotic syndrome. Nephrotic syndrome is managed in its own way while chyluria not amenable to pharmacological intervention is managed with sclerotherapy.

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“…Although LSG demonstrated enlarged lymphatics and nodes as a “fused band or mass”, 3D MR clearly showed dilated superficial lymphatic vessels as well as deep lymphatic trunks in addition to the characteristic tissue changes associated with LED. [34] In a more recent and larger study, with 710 patients with primary or secondary LED, Liu and Zang, administered gadobenate dimeglumine intradermally to obtain contrast-enhanced MR lymphographic imaging. This technique provided detailed anatomic and functional information on both the lymphatic vessels and nodes (see Figure 4), and showed tortuous and dilated collecting lymphatics in greater detail than LS.…”

Section: Diagnosismentioning

confidence: 99%

New diagnostic modalities in the evaluation of lymphedema

O’Donnell

Rasmussen

Sevick‐Muraca

2017

Journal of Vascular Surgery: Venous and Lymphatic Disorders

120

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Objective Currently lymphedema (LED) is typically diagnosed clinically on the basis of a patient’s history and characteristic physical findings. While the diagnosis of LED is sometimes confirmed by lymphoscintigraphy (LSG), the technique is limited in its ability to identify pathology and guide therapy. Recent advancements provide opportunities for new imaging techniques to not only assist in the diagnosis of LED, based on anatomical changes, but also to assess contractile function and to guide therapeutic intervention. The purpose of this contribution is to review these imaging techniques. Methods Literature for each technique is reviewed and discussed and the evidence for each of these new diagnostic techniques were assessed on several criteria to determine if each could: 1) establish whether disease is present; 2) determine the severity of the disease process; 3) define the pathophysiology of the disease process; 4) demonstrate whether intervention is possible as well as what type; and 5) objectively grade the response to therapy. Results LSG is currently the standard test to confirm LED. Duplex ultrasound (DUS) is a simple, readily available non-invasive test that can identify LED by specific tissue characteristics and the response to therapy. MRI and CT scans similarly demonstrate the alterations in epidermal and subcutaneous tissue, but the latter can also detect obstructing neoplasms as a cause of secondary LED. Moreover, MR lymphangiography details lymphatic vessels and nodes and their function. Newer fluorescence imaging techniques provide opportunities to imaging lymphatic anatomy and function. Visible micro lymphangiography by fluorescein sodium is limited by tissue light absorption to imaging depths of 200 μm. Near-infrared fluorescence (NIRF) lymphatic imaging [NIRF-LI], a newer test using intradermal injection of indocyanine green, can penetrate several centimeters of tissue and can visualize the initial and conducting lymphatics, the lymph node basins, as well as the active function of lymphangions (the key module) in exquisite detail. Conclusions The availability and the non-invasive nature of DUS should make this modality the first choice for establishing the diagnosis of LED based on tissue changes. Further studies comparing DUS to LSG, however, are needed. The costs of MRI and CT limit their adoption as a means to regularly assess the lymphatics. While lymphatic truncal anatomy and transit times can be delineated by the older technique of LSG, NIRF-LI is rapid, highly sensitive, repeatable, and provides exquisite detail for lymphatic vessel anatomy/function of the lymphangions as well as the response to therapy.

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Noncontrast three-dimensional magnetic resonance imaging vs lymphoscintigraphy in the evaluation of lymph circulation disorders: A comparative study

Cited by 67 publications

References 1 publication

Lower Body Lymphedema in Patients with Gynecologic Cancer

Lower Body Lymphedema in Patients with Gynecologic Cancer

Analysis of case series of milky urine: A single center and departmental clinical experience with emphasis on management perspectives: A prospective observational study

New diagnostic modalities in the evaluation of lymphedema

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