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Lower limb lymphoscintigraphy patterns among patients with lower limb lymphedema: a pictorial essay

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Abstract

Purpose

Lymphoscintigraphy is the imaging of choice in diagnosis of lymphedema. Diagnosis is made on the basis of qualitative assessment of tracer distribution at specified time points. A sound knowledge of the anatomy and function of the lymphatic system combined with understanding of tracer propagation and distribution through the lymphatic system is necessary for accurate diagnosis of lymphedema.

Technique and image findings

Lymphoscintigraphy at Aga Khan University Hospital (AKUH) is performed by intradermal injection of Tc 99m nanocolloid with planar imaging performed at 5, 15 min and 1½ h for reproducibility. Images are analyzed mainly by qualitative parameters that relate to tracer kinetics within the lymphatic system. We describe different image appearances which represent the various patterns of tracer distribution in normal lymphatics and with lymphedema.

Conclusion

Lymphoscintigraphy is a highly accurate and reproducible technique for the evaluation of the lymphedema. A thorough knowledge of the various imaging appearances on lymphoscintigraphy is necessary for proper interpretation of images. Addition of quantitative parameters would increase the accuracy.

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Authors and Affiliations

  1. Agakhan University Hospital, Nairobi, 3rd Parklands Avenue, P O Box 30270 – 00100, Nairobi, Kenya

    Edward C. Nganga, Samuel Gitau & Khalid Makhdomi

Authors
  1. Edward C. Nganga
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  2. Samuel Gitau
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  3. Khalid Makhdomi
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Corresponding author

Correspondence to Edward C. Nganga.

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Informed consent

Verbal and written informed consent was obtained from the patients or next of kin. The standard protocol including dosage, route of radiotracer injection and time to imaging were not altered. Potential patient identifiers were not used.

Conflict of interest

The authors have no conflict of interest to declare.

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Nganga, E.C., Gitau, S. & Makhdomi, K. Lower limb lymphoscintigraphy patterns among patients with lower limb lymphedema: a pictorial essay. Clin Transl Imaging 6, 135–143 (2018). https://doi.org/10.1007/s40336-018-0266-y

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  • DOI: https://doi.org/10.1007/s40336-018-0266-y

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