吲哚菁绿淋巴造影诊断原发性肢体淋巴水肿

摘要

目的 探讨吲哚菁绿淋巴造影在原发性肢体淋巴水肿中的诊断价值.方法 对61例原发性淋巴水肿患者进行吲哚菁绿淋巴造影,以健侧肢体作为对照组.皮内注射造影剂吲哚菁绿后,采用PDE红外荧光定位仪观察并记录淋巴管道显影情况、肢体显影范围随时间变化情况,计算淋巴管收缩频率.结果 健肢淋巴管显影清晰,注射后30 min检测均可见相应腹股沟或腋窝淋巴结显影,淋巴管收缩频率为1次/min(0.33～5.00次/min).94.8％患肢表现出淋巴管、淋巴结显影延迟,所有患肢均伴真皮反流或造影剂皮下弥散,部分患肢可见淋巴管形态结构及收缩方式异常,但收缩频率较对照组增加,为2.5次/min(0.5～7.0次/min).结论 吲哚菁绿淋巴造影诊断淋巴水肿敏感度高、安全方便,研究其在原发性淋巴水肿中的影像学特点有助于深入理解淋巴循环障碍的病变基础与发病机制.%Objective To evaluate the diagnostic value of indocyanine green(ICG) lymphography in primary lymphedema of extremities.Methods 61 patients with limb lymphedema were enrolled in the study.The contralateral healthy limbs were used as controls.After intradermal injection of Indocyanine Green,dynamic observation of lymphatic vessels and lymph flow was performed using PDE near-infrared fluorescent instrument.The frequency of lymphatic contraction was calculated.Results Lymphatic vessel images were clearly visualized in healthy limbs.Inguinal or axillary lymph nodes can be visualized when examined 30 minutes after injection.Lymphatic contraction frequency was 1 (0.33-5.00) time per minute.94.8％ lymphedematous limb demonstrated delayed lymphatic vessel or lymph nodes."Dermal backflow" and diffused shadow pattern can be observed in all affected limbs.Abnormal lymphatic vasculature and contraction can be visualized.The frequency of lymphatic contraction in the affected limb was higher compared to controls:2.5 (0.5-7.0) times per minute.Conclusions ICG lymphography possess high sensitivity for lymphedema diagnosis.ICG lymphography furthers our understanding of pathophysiological alterations of lymphatic disorders.