[Lymphatic vessel imaging-Indications and clinical applications].

Radiologie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-04-17 DOI:10.1007/s00117-025-01451-z
Claus C Pieper
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Abstract

Background: The armamentarium of lymphatic imaging techniques and treatment concepts available at specialized centers has significantly increased in recent years. The rarity and complexity of lymphatic vascular diseases presents the particular challenge of implementing these methods in a meaningful and targeted manner in patient care; however, there are currently no generally accepted diagnostic guidelines.

Objective: Which lymphatic imaging technique is useful in which clinical situations?

Material and methods: This article provides an overview of clinical and technical considerations that are relevant for a targeted evaluation of indications for lymphatic imaging in a multidisciplinary diagnostic and therapeutic approach.

Results: The lymphatic vascular system can be affected by a wide range of primary and secondary pathologies, which often lead to relatively uniform clinical presentations (especially localized swellings, chylolymphatic effusions). In general, dedicated imaging should be discussed if a lymphatic vascular disease is suspected based on such a typical presentation. The choice of imaging strategy is then individually determined by the urgency of treatment, suspected localization and etiology of the pathology, comorbidities, specific properties of the imaging techniques, the treatment strategy pursued and local availability. When interpreting imaging and planning treatment, in addition to the large spectrum of different pathologies, the individual variability of the lymphatic system must also be taken into account.

Conclusion: An individual pretherapeutic assessment of lymphatic flow should nowadays be mandatory in order to be able to optimize the therapeutic approach for each patient with a suspected lymphatic vascular disease. Interdisciplinary patient care is of decisive importance.

淋巴管成像-适应症和临床应用。
背景:近年来,专业中心的淋巴成像技术和治疗理念的装备显著增加。淋巴血管疾病的罕见性和复杂性提出了在患者护理中以有意义和有针对性的方式实施这些方法的特殊挑战;然而,目前尚无普遍接受的诊断指南。目的:哪种淋巴成像技术在哪些临床情况下是有用的?材料和方法:本文概述了与多学科诊断和治疗方法中淋巴成像适应症的有针对性评估相关的临床和技术考虑。结果:淋巴血管系统可受到各种原发和继发病变的影响,这往往导致相对统一的临床表现(特别是局部肿胀,乳糜淋巴积液)。一般来说,如果基于这种典型的表现怀疑是淋巴血管疾病,应该讨论专门的影像学。成像策略的选择取决于治疗的紧迫性、疑似定位和病理的病因、合并症、成像技术的具体特性、所采用的治疗策略和当地的可用性。在解释影像学和计划治疗时,除了不同病理的大谱外,淋巴系统的个体可变性也必须考虑在内。结论:为了能够优化每个疑似淋巴血管疾病患者的治疗方法,目前必须对淋巴血流进行个体治疗前评估。跨学科的病人护理具有决定性的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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