Surgery Today

, Volume 44, Issue 6, pp 1048–1055

Re-evaluation of qualitative lymphangioscintigraphic findings in secondary lower extremity lymphedema

  • Kotaro Suehiro
  • Noriyasu Morikage
  • Masanori Murakami
  • Osamu Yamashita
  • Makoto Samura
  • Kimikazu Hamano
Original Article

DOI: 10.1007/s00595-013-0819-7

Cite this article as:
Suehiro, K., Morikage, N., Murakami, M. et al. Surg Today (2014) 44: 1048. doi:10.1007/s00595-013-0819-7

Abstract

Purpose

To re-evaluate whether qualitative lymphangioscintigraphy (LAS) findings are sensitive enough to diagnose or classify the clinical severity of lower extremity lymphedema.

Methods

LAS was performed in 78 extremities with lymphedema and 24 extremities without lymphedema between April, 2009 and March, 2012. We assessed the proportion of extremities in which there was no visual evidence of the ilioinguinal lymph nodes (LN-60) or the lymphatic trunk (Tr-60) 60 min after tracer injection, the number of visualized ilioinguinal lymph nodes (#LN), and the proportion of extremities with dermal backflow (pDBF) and lymph stasis (pLS). These were associated with the International Society of Lymphology (ISL) clinical stage.

Results

LN-60, Tr-60, #LN, pDBF, and pLS, especially when extending into both the thigh and lower leg, were significantly associated with the ISL stage. The sensitivity of LN-60, Tr-60, and #LN <2 for diagnosing lymphedema was 49, 47, and 59 %, respectively, with no significant difference among these parameters for consecutive ISL stages.

Conclusions

None of the above measures was sufficiently sensitive to diagnose lymphedema or classify the severity of the disease; however, each of these criteria can aid in diagnosis, by excluding other diseases and assessing disease pathophysiology.

Keywords

Leg Lymphedema Lymphangioscintigraphy 

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Kotaro Suehiro
    • 1
  • Noriyasu Morikage
    • 1
  • Masanori Murakami
    • 1
  • Osamu Yamashita
    • 1
  • Makoto Samura
    • 1
  • Kimikazu Hamano
    • 1
  1. 1.Division of Vascular Surgery, Department of Surgery and Clinical ScienceYamaguchi University Graduate School of MedicineUbeJapan

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