Lymphoscintigraphy to confirm the clinical diagnosis of lymphedema

Journal Article · Fri Sep 01 04:00:00 EDT 1989 · Journal of Vascular Surgery; (USA)

DOI:https://doi.org/10.1067/mva.1989.14117· OSTI ID:5227129

Golueke, P J; Montgomery, R A; Petronis, J D; Minken, S L; Perler, B A; Williams, G M ^[1]

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1. Johns Hopkins Medical Institutions, Baltimore, MD (USA)

Confirmation of the diagnosis of lymphedema often requires lymphangiography, a procedure that is painful for the patient and technically demanding. Radioisotope lymphoscintigraphy is a relatively new technique that uses technetium 99 m antimony trisulfide colloid to produce a diagnostic image similar to a lymphangiogram. The procedure requires a single subcutaneous injection in the involved extremity, and images are obtained 3 hours later. It is technically easy to perform, produces minimal discomfort for the patient, and has no adverse effects. We have recently used radioisotope lymphoscintigraphy to evaluate 17 patients with extremity edema. These patients initially had a presumed diagnosis of lymphedema involving the upper or lower extremity. Lymphoscintigraphy confirmed the diagnosis of lymphedema in 12 (70.6%) patients. In five of the 17 patients (29.4%) the clinical impression of lymphedema was not supported by lymphoscintigraphy, leading to alternative diagnoses such as lipomatosis, venous insufficiency (two patients), congestive heart failure, and disuse edema. In all patients with secondary lymphedema the lymphatic system in the involved extremity could be partially visualized. Conversely, three of four patients with primary lymphedema had no ascent of the tracer from the foot and no lymphatic channels could be visualized. Lymphoscintigraphy is relatively easy to perform, safe, minimally invasive, and not uncomfortable for the patient. It is useful in differentiating lymphedema from other causes of extremity edema, allowing institution of appropriate therapy.

• OSTI ID: 5227129
• Journal Information: Journal of Vascular Surgery; (USA), Journal Name: Journal of Vascular Surgery; (USA) Vol. 10:3; ISSN 0741-5214; ISSN JVSUE
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
HOURS LIVING RADIOISOTOPES
IMMUNE SYSTEM DISEASES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LYMPHATIC SYSTEM
NUCLEI
ODD-EVEN NUCLEI
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
TECHNETIUM 99
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES