淋巴显像与吲哚菁绿淋巴显像——哪个是淋巴水肿显像的金标准?

Brian A. Figueroa, Jacob Lammers, Mazen Al-Malak, S. Pandey, Wei F. Chen
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摘要

早期发现和治疗可以减缓淋巴水肿的进展。诊断淋巴水肿在亚临床阶段,需要一个敏感的影像学模式。一个世纪以来,基于放射性同位素的淋巴闪烁成像(LSG)一直是“黄金标准”。吲哚菁绿淋巴造影术(ICGL)被用于诊断和分级所有淋巴水肿患者。本研究比较ICGL与LSG的疾病检出率。对2020年2月至2022年4月期间因淋巴水肿就诊的所有患者进行图表回顾。在有症状/无症状的肢体中同时接受LSG和ICG治疗四肢水肿的患者被纳入研究。23例患者共50条肢体符合纳入标准。其中37例有症状,13例无症状。有症状肢体中,LSG淋巴功能障碍检出率为26/37(70%),ICG淋巴功能障碍检出率为37/37(100%)(p < 0.01)。无症状组LSG检出1/13(8%)条肢体病变,ICG检出8/13(62%)条肢体淋巴功能障碍(p < 0.01)。LSG的漏诊率为30%,而ICG无漏诊率(p < 0.01)。与ICG相比,LSG遗漏无症状疾病的概率为54% (p < 0.01)。综上所述,与LSG相比,ICG淋巴造影具有更高的淋巴功能障碍检出率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lymphoscintigraphy versus Indocyanine Green Lymphography—Which Should Be the Gold Standard for Lymphedema Imaging?
Early detection and treatment can slow the progression of lymphedema. To diagnose lymphedema in the subclinical phase, a sensitive imaging modality is required. Radioisotope-based lymphoscintigraphy (LSG) has been the “gold standard” for a century. Indocyanine green lymphography (ICGL) is being used at our institute for diagnosing and grading all lymphedema patients. In this study, ICGL disease detection rate was compared to that of LSG. Chart review of all patients who presented for lymphedema consult between February 2020 and April 2022 was conducted. Patients who underwent both LSG and ICG for extremity edema in symptomatic/asymptomatic limbs were included. A total of 50 limbs in 23 patients met the inclusion criteria. Of those, 37 were symptomatic and 13 were asymptomatic. LSG detected lymphatic dysfunction in 26/37(70%) of the symptomatic limbs while ICG detected the same in 37/37(100%) limbs (p < 0.01). In the asymptomatic group, LSG detected the disease in 1/13(8%) limbs while ICG detected lymphatic dysfunction in 8/13 (62%) limbs (p < 0.01). LSG missed symptomatic limbs 30% of the time, whereas ICG did not miss any symptomatic limbs (p < 0.01). LSG missed asymptomatic disease 54% of the time (p < 0.01) compared to ICG. In conclusion, ICG lymphography was determined to have a higher lymphatic dysfunction detection rate compared to LSG.
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