Magnetic resonance lymphangiography: Correlation with indocyanine green lymphangiography in lower limb lymphedema

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-08-05 DOI:10.1016/j.bjps.2025.07.034

Minge Zhang , Liqi Yi , Chong Liu , Jinbiao Huang , Yan Chen , Jingjing Wang , Runyu Tang , Hai Yang

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引用次数: 0

Abstract

Background

Indocyanine green (ICG) lymphography is considered the gold standard method for real-time imaging of the lymphatic vessels. Despite extensive literature on the effectiveness of different imaging modalities, research comparing the reliability of ICG lymphography and magnetic resonance lymphangiography (MRL) is limited. We retrospectively analyzed and compared the capability of MRL and ICG lymphangiography to detect lower limb lymphoedema abnormalities.

Methods

This monocentric cohort study included patients who had examinations and surgeries between September 2021 and December 2023. The assessment comprised scoring the severity levels of the drainage pattern, lymphatic vessel conspicuity, anatomic level of lymphatic vessel enhancement, contrast medium deposition in the foot, and the anatomic coverage of dermal backflow. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRL and ICG lymphangiography were calculated.

Results

A total of 89 patients with clinically proven moderate to severe lymphoedema (stages II–III) affecting 92 lower limbs were enrolled. Good to excellent agreement was determined between MRL and ICG lymphography in drainage pattern (k=0.710), contrast medium deposition in the foot (k=0.933), and anatomic coverage of dermal backflow (k=0.653). Anatomical level of lymphatic vessel enhancement was in moderate correlation (k=0.524), and the visualization of lymphatic vessels was correlated (k=0.330) between the two modalities. MRL demonstrated lower NPV (50% vs 100%) in lymphatic vessel conspicuity but better sensitivity (100% vs 98%) and NPV (100% vs 97.6%) of contrast medium deposition in the foot as compared to ICG lymphography.

Conclusions

MRL demonstrated better performance on the lymphatic vessel conspicuity when dermal backflow is obvious. For normal lymphatic vessels, ICG lymphography provided a better description.

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磁共振淋巴管造影：与下肢淋巴水肿的吲哚菁绿淋巴管造影的相关性

吲哚菁绿（ICG）淋巴管造影被认为是淋巴管实时成像的金标准方法。尽管有大量文献关于不同成像方式的有效性，但比较ICG淋巴造影和磁共振淋巴管造影（MRL）可靠性的研究有限。我们回顾性分析和比较MRL和ICG淋巴管造影检测下肢淋巴水肿异常的能力。方法本单中心队列研究纳入了2021年9月至2023年12月期间接受检查和手术的患者。评估包括对引流模式的严重程度、淋巴管的显著性、淋巴管增强的解剖水平、足部造影剂沉积和真皮回流的解剖覆盖进行评分。计算MRL和ICG淋巴管造影的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。结果共纳入临床证实的中度至重度淋巴水肿（II-III期）患者89例，共92条下肢。MRL和ICG淋巴造影在引流模式（k=0.710）、足部造影剂沉积（k=0.933）和真皮回流的解剖覆盖（k=0.653）方面的一致性良好至极好。两种方式的淋巴管增强解剖水平呈正相关（k=0.524），淋巴管显像呈正相关（k=0.330）。与ICG淋巴造影相比，MRL显示淋巴管显著性的NPV较低（50%对100%），但对足部造影剂沉积的敏感性（100%对98%）和NPV（100%对97.6%）更好。结论在真皮回流明显的情况下，smrl对淋巴管显影效果较好。对于正常的淋巴管，ICG淋巴管造影提供了更好的描述。

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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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.