title: Swollen lower extremity: role of MR imaging.
abstract: The authors assessed the use of magnetic resonance imaging in differentiating lymphedema, phlebedema, and lipedema of the lower limb. They examined 14 patients: five with lipedema, five with lymphedema, and four with phlebedema. T1- and T2-weighted transaxial sequences were performed before administration of gadolinium tetraazacyclododecane-tetraacetic acid (DOTA) and T1-weighted spin-echo sequences were performed after administration of Gd-DOTA in each patient. Images of patients with lipedema showed homogeneously enlarged subcutaneous layers, with no increase in signal intensity at T2-weighted imaging or after Gd-DOTA administration. Patients with phlebedema had areas containing increased amounts of fluid within muscle and subcutaneous fat. In lymphedema, a honeycomb pattern above the fascia between muscle and subcutis was observed, with a marked increase in signal intensity at T2-weighted imaging. After Gd-DOTA administration, there was only a slight increase in signal intensity in the subcutis in lymphedema and phlebedema and a moderate increase in signal intensity in muscle in phlebedema.
authors.affiliation: Department of Medical Radiology, University Hospital Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Duewell
authors.forename: K D
authors.initials: KD
authors.lastname: Hagspiel
authors.forename: J
authors.initials: J
authors.lastname: Zuber
authors.forename: G K
authors.initials: GK
authors.lastname: von Schulthess
authors.forename: A
authors.initials: A
authors.lastname: Bollinger
authors.forename: W A
authors.initials: WA
authors.lastname: Fuchs
mesh_terms: D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis*; D005223:Fats; D005260:Female; D005682:Gadolinium; D006571:Heterocyclic Compounds; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D014648:Varicose Veins / Q000175:diagnosis; D014689:Venous Insufficiency / Q000175:diagnosis
chemical_list: D003287:Contrast Media; D005223:Fats; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate; D005682:Gadolinium