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Primary lower limb lymphoedema: classification with non-contrast MR lymphography

  • Vascular-Interventional
  • Published:
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Abstract

Purpose

The purpose of the present study was to analyse the performance of non-contrast MR lymphography for the classification of primary lower limb lymphoedema in 121 consecutive patients with 187 primary lower limb lymphoedemas.

Materials and methods

121 consecutive patients with clinically diagnosed primary lower limb lymphoedema underwent non-contrast MR lymphography with a free-breathing 3D fast spin-echo sequence with a very long TR/TE (4000/884 ms). MR examinations were retrospectively reviewed for severity of lymphoedema (absent, mild, moderate, severe) and characteristics of inguinal lymph nodes and iliac and inguinal lymphatic trunks graded as aplasic (no lymph nodes or lymphatic trunks), hypoplasic (less lymph nodes or lymphatic trunks), normal and hyperplasic (more lymph nodes or more and/or dilated trunks).

Results

There was an excellent correlation between clinical stage and severity of lymphoedema (Cramer’s V of 0,73 (p < 0.001)). Differentiation was feasible between inguinal lymphatic vessel aplasia (21%), hypoplasia (15%), normal pattern (53%) and hyperplasia (11%).

Severe lymphoedema was observed in 46% of aplasic patterns and in 37% of hyperplasic patterns, but in only 15% of hypoplasic patterns and never observed in normal patterns (p < 0.001).

Conclusion

Non-contrast MR lymphography is able to classify primary lower limb lymphoedemas into hyperplasic, aplasic, hypoplasic and normal patterns.

Key Points

• Non-contrast MR lymphography is able to classify primary lower limb lymphoedemas.

• Lymphoedema can be classified in hyperplasic, aplasic, hypoplasic and normal patterns.

• Non-contrast MR lymphography can optimize clinical management of primary lower limb lymphoedemas.

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Acknowledgments

Julien Bouvier for technical assistance.

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Authors and Affiliations

  1. Department of Radiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Lionel Arrivé, S. Derhy, S. El Mouhadi, L. Monnier-Cholley & Y. Menu

  2. Faculté de Médecine Pierre et Marie Curie, Sorbonne Universités, UPMC Université Paris 06, Paris, France

    Lionel Arrivé, S. Derhy, S. El Mouhadi, L. Monnier-Cholley & Y. Menu

  3. Department of Emergency Medicine, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France

    B. Dahan

  4. Department of Thoracic Surgery, HEGP, 20 Rue Leblanc, 75015, Paris, France

    C. Becker

Authors
  1. Lionel Arrivé
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  2. S. Derhy
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  3. B. Dahan
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  4. S. El Mouhadi
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  6. Y. Menu
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  7. C. Becker
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Corresponding author

Correspondence to Lionel Arrivé.

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Guarantor

The scientific guarantor of this publication is Lionel Arrivé M.D..

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

One of the authors, Benjamin Dahan, has significant statistical expertise.

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Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

• retrospective

• observational

• performed at one institution

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Arrivé, L., Derhy, S., Dahan, B. et al. Primary lower limb lymphoedema: classification with non-contrast MR lymphography. Eur Radiol 28, 291–300 (2018). https://doi.org/10.1007/s00330-017-4948-z

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  • DOI: https://doi.org/10.1007/s00330-017-4948-z

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