MR淋巴造影在肢体淋巴水肿诊断中的价值  

The assessment of lymphatic system in lymphedema with magnetic resonance lymphangiography

作　　者：赵子周[1] 李苏芹[1] 王丽[1] 华小兰[1] 唐辉[1] 路青[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127

出　　处：《实用放射学杂志》2017年第3期338-342,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81271638,81371622）;上海市科委浦江人才计划项目（15PJ1405200）.

摘　　要：目的 评估MR淋巴造影（MRL）对肢体淋巴水肿的诊断价值.方法 运用3.0T MR对582例肢体淋巴水肿患者进行MRL.并对淋巴结形态及显影情况,淋巴管数目和淋巴速度等进行评估.结果 原发性与继发性淋巴水肿淋巴回流障碍MRL均显示或为淋巴结受累、或为淋巴管受累、或为两者均受累.根据MRL显示的淋巴管数目,原发性淋巴水肿可分为淋巴系统不发育、发育不全和淋巴系统增生3类;继发性淋巴水肿可分淋巴管闭塞减少型和淋巴管开放增多型.动态MRL显示原发性淋巴水肿受累肢体淋巴回流速度平均为（1.0±0.62）cm/min,显著慢于继发性受累肢体平均流速（2.22±1.64）cm/min（P〈0.01）.在原发性与继发性淋巴水肿中,对侧相比患侧淋巴结MRL均表现为显影数目少、显影延迟和显影信号低.结论 动态MRL能够评估肢体淋巴水肿淋巴系统形态及功能改变,为淋巴水肿诊断提供有力影像手段.Objective To evaluate the MR lymphangiography （MRL）in diagnosis of limb lymphedema.Methods A total of 582 patients with lymphedemtous limbs were enrolled in the study,MRL was performed at 3.0T MR.The morphology and enhancement of the lymph nodes,the number of lymphatic vessels and the lymph flow were evaluated.Results No matter in primary or secondary lymphedema,there were patients showed only lymph nodes affected,or only lymph vessels affected,and some patients showed both affected.Lymphatic aplasia,hypoplasia or hyperplasia were showed in primary lymphedema.Obstruction lymphatic vessels,and lym-phangiectasia were showed in secondary lymphedema.The velocity of lymph flow was （1.0±0.62）cm/min in affected limb of pa-tients with primary lymphedema,which was significantly slower than that of affected limb of patients with secondary lymphedema （2.22±1.64）cm/min（P〈0.01）in dynamic contrast-enhanced MRL.In both type of lymphedema,the contrast enhanced lymph nodes showed less nodes with delayed enhancement and lower signal intensity,compared to that of lymph nodes in the contralateral normal side.Conclusion Dynamic contrast-enhanced MRL is helpful for assessing the anatomical and functional status of lymphatic system in lymphedematous limb.This new imaging techniques provides a powerful tool for the diagnosis of lymphedema.

关 键 词：淋巴水肿 淋巴管 磁共振淋巴造影 

分 类 号：R551.2[医药卫生—血液循环系统疾病] R445.2[医药卫生—内科学]