Lymphoscintigraphic Findings in Chylous Reflux in a Lower Extremity

Berenji, Gholam R.; Iker, Emily; Glass, Edwin C.

doi:10.1097/rlu.0b013e318123eddd

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…The indications for lymphoscintigraphy include primary lymphatic dysplasia, secondary lymphatic dysplasia, primary lymphedema, congenital lymphedema, secondary lymphedema, and chylous leakage (chylous ascites and chylothorax) [12]. The lymphoscintigraphy technique has also been proposed, by some authors, for the evaluation of thoracic duct abnormalities [13].…”

Section: Indicationsmentioning

confidence: 99%

Procedural Recommendations for Lymphoscintigraphy in the Diagnosis of Peripheral Lymphedema: the Genoa Protocol

Villa

Campisi²,

Ryan

et al. 2019

Nucl Med Mol Imaging

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Introduction Lymphoscintigraphy is the gold standard for imaging in the diagnosis of peripheral lymphedema. However, there are no clear guidelines to standardize usage across centers, and as such, large variability exists. The aim of this perspectives paper is to draw upon the knowledge and extensive experience of lymphoscintigraphy here in Genoa, Italy, from our center of excellence in the assessment and treatment of lymphatic disorders for over 30 years to provide general guidelines for nuclear medicine specialists. Method The authors describe the technical characteristics of lymphoscintigraphy in patients with limb swelling. Radioactive tracers, dosage, administration sites, and the rationale for a two-compartment protocol with the inclusion of subfascial lymphatic vessels are all given in detail.Results Examples of lymphoscintigraphic investigations with various subgroups of patients are discussed. The concept of a transport index (TI) for semi-quantitative analysis of normal/pathological lymphatic flow is introduced. Different concepts of injection techniques are outlined. Discussion It is past time that lymphoscintigraphy in the diagnosis of lymphatic disorders becomes standardized. This represents our first attempt to outline a clear protocol and delineate the relevant points for lymphoscintigraphy in this patient population.

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Section: Indicationsmentioning

confidence: 99%

Procedural Recommendations for Lymphoscintigraphy in the Diagnosis of Peripheral Lymphedema: the Genoa Protocol

Villa

Campisi²,

Ryan

et al. 2019

Nucl Med Mol Imaging

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show abstract

“…Hypoproteinemia was noted, often with other metabolic disturbances, and the long-term prognosis was poor. These kinds of lymphatic disorders have recently been diagnosed by less invasive methods such as MRI, lymphoscintigraphy, 2 or fluorescence lymphography instead of conventional lymphangiography using oily material that might cause oil emboli in the lungs. 3 This case can be classified into Syndrome I because it has the typi- cal symptoms and signs: megalymphatics, simple hemangioma, and edema.…”

Section: Discussionmentioning

confidence: 99%

Lymphaticovenous shunt for the treatment of chylous reflux by subcutaneous vein grafts with valves between megalymphatics and the great saphenous vein: A case report

et al. 2010

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Chylous reflux is a rare disorder in which chyle flows antidromically from its normal route to the extremities, thorax, abdominal cavity, or other parts of the body. We present a case of chylous reflux with megalymphatics in a 28-year-old boy who presented chylorrhea in the foot, leg, and external genitalia, lymphedema, and hemangioma in the affected limb. Lymphaticovenous shunts using subcutaneous vein grafts with valves were applied to the patient for treatment of repeated chylorrhea. After surgery, the patient has not complained of chylorrhea and been freed from conservative physiotherapy such as bandaging or application of compression stockings for lymphedema for two years. A subcutaneous vein graft with valves may be considered a useful method as a shunt between incompetent and dilated lymphatics and veins instead of a saphenous vein graft in the treatment of chylous reflux in lower extremities. We discuss these treatments based on the literature about chylous disorders.

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“…For special indications, such as chylous reflux, lymphoscintigraphy can be useful (discussed subsequently). 26…”

Section: Specialized Diagnostic Proceduresmentioning

confidence: 99%

Diagnosis and therapy in children with lymphoedema

Damstra

Mortimer

2008

Phlebology

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Lymphoscintigraphic Findings in Chylous Reflux in a Lower Extremity

Cited by 6 publications

References 11 publications

Procedural Recommendations for Lymphoscintigraphy in the Diagnosis of Peripheral Lymphedema: the Genoa Protocol

Procedural Recommendations for Lymphoscintigraphy in the Diagnosis of Peripheral Lymphedema: the Genoa Protocol

Lymphaticovenous shunt for the treatment of chylous reflux by subcutaneous vein grafts with valves between megalymphatics and the great saphenous vein: A case report

Diagnosis and therapy in children with lymphoedema

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