Correlation with Lymphoscintigraphy and MDCT in Patients with Clinically Suspected Lymphedema

Abstract

Purpose : Lymphedema can cause significant morbidity such as infection and inability in the activity of daily living. MDCT is a relatively new technique with excellent availability, while lymphoscintigraphy(LSG) is widely used as a gold standard but somewhat inconvenient and difficult to read out. We retrospectively studied the pattern of LSG and compared to the MDCT findings in patients with swollen limbs to find their roles for diagnosis and managing according to the causes of lymphedema.

Materials and methods : Tc99m-colloid LSG and MDCT with contrast enhancement were done in 68 patients with swollen lower extremities (56 female, 12 male; range, 17-86 years). We considered LSG findings of delayed lymphatic flow, absence of inguinal/iliac lymph node uptake, and dermal backflow as abnormal and also found subcutaneous honeycomb appearance and dermal thickening as abnormal findings on CT scan.

Results : In 35 patients with normal LSG, MDCT illustrated various causes of limb swelling such as deep vein thrombosis(n=4), varicose (n=3), recurred malignancy(n=4), thyroid disease(n=2) and renal disease(n=1). However, subcutaneous edema and dermal thickening was not found only in simple obese patients. Patients with positive findings on both LSG and MDCT (n=30) were all secondary lymphedema from previous surgery except for one patient with cellulitis.

Conclusion : This exhibit showed that the LSG and MDCT are highly correlated and they have peculiar advantages each other. MDCT allows analysis of extent and severity of soft tissue changes as well as could reveal causes of swollen limbs especially when LGS is negative. document and exclude causes of limb swelling to enable effective therapies can be implemented