• Assaf A Zeltzer, Carola Brussaard, Merel Koning, Randy De Baerdemaeker, Benoit Hendrickx, Moustapha Hamdi, and Johan de Mey.
• Department of Plastic and Reconstructive Surgery, University Hospital Brussels (VUB), Brussel, Belgium.
• J Surg Oncol. 2018 Sep 1; 118 (3): 407-415.

Background And ObjectivesLymphedema is caused by insufficient lymphatic drainage leading to abnormal accumulation of interstitial fluid within soft tissues. Lympho-venous anastomosis (LVA), as a surgical option for selected patients, is widely applied. Through preoperative localization of functional lymphatics with indocyanine green, real time visualization of functioning lymphatic vessels is possible. This examination is time consuming and operator dependant and is not suitable to differentiate the ratio of fat hypertrophy to liquid edema. We investigated whether MR lymphangiography is accurate for imaging functional lymphatics and adjacent veins in arms. Furthermore, we investigated the accuracy and predictability of preoperative mapping for the feasibility of performing LVA and the preoperative decision making in lymphedema surgery.MethodsA prospective study was performed in which 25 patients suffering from lymphedema of the upper extremity were examined. MR lymphography with contrast agent injection in a deep dermal plane was performed.ResultsPrecise localization of lymphatic vessels crossing a vein was achieved in 18 of 25 arms. In 16 of the 18 patients in whom functional lymphatics were localized with an adjacent vein on MRI an LVA was performed successfully.ConclusionsMR lymphangiography is an accurate and reproducible method for imaging and mapping of lymphatic channels in the lymphedemateous limb.© 2018 Wiley Periodicals, Inc.

33 keywords...

hide…