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acellular lymph escapes clinical interroga- nique permits to assess the lymphatic func- emerging non-microscopic imaging tech-
tion using ultrasound. So different imaging tion by measuring the time from the injec- nology that collects tissue-scattered light to
on
strategies have been developed in the chal- tion in distant digits and the appearance of assess conducting and collecting lymphatic
lenging field of the lymphatic system. the radionuclide tracer in the major lymph vessels at greater penetration depths, but
Indirect MR lymphangiography can be nodes, such as inguinal or iliac.7-9 with lower resolution than the initial lym-
e
performed by injection of gadolinium-based Fluorescence micro-lymphangiography phatic imaged with FML.11 In clinical prac-
contrast dye into the dermal and subcuta-
neous spaces. For instance indirect MR
us
(FML) is a fluorescence technique widely
used in animal models of disease, but with
tice could be useful to assess subclinical
lymphedema before chronic worsening.
lymphangiography in the upper and lower scarce usage in humans. Owing to the limit- Unlike other lymphatic imaging
al
extremities of lymphedema patients has ed penetration depth of light at visible approaches, NIRF lymphatic images can be
excellent resolution and more detailed lym- wavelengths and tissue scattering, only the collected rapidly with millisecond acquisi-
ci
phatic routes visualization as compared to initial capillaries within the first 100 to 150 tions,12 allowing for the non-invasive inter-
er
routine lymphoscintigraphy.1-4 Moreover, microns of tissue depth can be visualized in rogation of function and the quantitative
the recent introduction of 3D isotropic fat- humans.10 assessment of the lymph-pump frequency
m
References
1. Lohrmann C, Foeldi E, Langer M.
Indirect magnetic resonance lymphan-
giography in patients with lymphedema
Figure 1. A) Indirect magnetic resonance (MR) lymphangiography in a normal case, with preliminary results in humans. Eur J
the lymphatic routes of the medial aspect of the lower extremity depicted by the white Radiol 2006;59:401-6.
2. Lohrmann C, Foeldi E, Langer M.
arrows. B) Indirect MR lymphangiography in a primary lymphedema case with aplasia
Diffuse lymphangiomatosis with genital
of lymphatic collectors of the lower limb. The white arrow depicts the ecstasies of the
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