| 朱瑞森,陆汉魁,朱继芳,罗全勇,陈立波.肢体淋巴性水肿的99Tcm DX显像的临床分析[J].中国医学影像技术,2006,22(7):1087~1089 |
| 肢体淋巴性水肿的99Tcm DX显像的临床分析 |
| 99Tcm-DX imaging for extremity lymphedema |
| 投稿时间：2006-01-26 修订日期：2006-05-10 |
| DOI： |
| 中文关键词: 淋巴显像 肢体淋巴性水肿 99Tcm-DX显像 |
| 英文关键词:Lymph imaging Extremity lymphedema 99Tcm-DX imaging |
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| 中文摘要: |
| 目的 研究99Tcm-DX淋巴显像与肢体淋巴性水肿(ELE)的分类与病因的关系及其图像特点。方法 临床诊断511例ELE,其中原发性淋巴性水肿(PLE)14例,感染性继发性淋巴性水肿(SLE)166例,损伤性SLE 127例,不明原因SLE 204例。采用99Tcm-DX显像,每个肢体足(手)趾(指)间蹼皮下注射99Tcm-DX 5mCi,1 h后显像。结果 PLE显像图特点为肢体淋巴集合管和腹股沟淋巴结(或腋下淋巴结)不显影,药物滞留在注射点。感染性SLE显像为肢体局部感染区软组织内放射性集积,根据感染区淋巴管受损程度,感染区以上淋巴集合管显影或不显影,腹股沟淋巴结(腋下淋巴结)显影或不显影。损伤性SLE显像特点,患肢软组织内放射性弥漫性集积,淋巴集合管和腹股沟淋巴结(腋下淋巴结)不显影,轻者肢体可见淋巴管网显影。结论 99Tcm-DX是一种简便快速灵敏的诊断ELE方法,它通过肢体软组织内放射性分布状况,淋巴结及淋巴管显影情况反映肢体淋巴回流的动力学变化,此变化与ELE类型、病因及淋巴管受损程度相关。并对疾病预后的估计,疗效有很高的临床价值。 |
| 英文摘要: |
| Objective To investigate the classification and the pathogenesis of extremity lymphedema (ELE) by means of 99Tcm-DX imaging technique. Methods Five hundred and eleven patients were diagnosed as ELE, 14 cases were diagnosed as primary lymphedema (PLE), 166 cases as infective secondary lymphedema (SLE), 127 cases as injury SLE, unidentified SLE 204 cases. The 99Tcm-DX imaging was adopted and 5mCi 99Tcm-DX was inoculated subcutaneously at the web of extremities (hand and toe). Images were obtained one hour afterwards. Results The characteristics of PLE graphics indicated that the lymphatic collectors and inguinal lymph nodes of extremities (or axillary lymph nodes) were not imaged. For the patients with congenital ELE, the radioactive drug was detained in the inoculated site after injection. For the infectious SLE patients, the imaging graphics showed that the radioactivity was accumulated in the soft tissue of infectious area; the intensity varied according to the extent of injury in the lymphoduct of lesions. Lymphatic collector (up to infectious area) and inguinal lymph node (axillary lymph node) showed image or nonimage. The characteristics of injury SLE graphics indicated: diffused radioactivity accumulated in the wounded parenchyma tissue; no imaging manifested in the lymphatic collector and inguinal lymph node (axillary lymph node); in the mild cases, image was shown in the lymphoduct network of extremities. Conclusion The 99Tcm-DX technique is a simple, rapid and sensitive method for the diagnosis of ELE. The radioactive distribution in the parenchyma of extremities and imaging graphics of lymph nodes and lymph ducts reflect the kinetic fluctuation of lymph backflow. The variation correlates with the typing of ELE, pathogenesis and the damage of lymph ducts. This technique is highly significant clinically of the prognosis and therapeutic effect. |
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