[The current role of lymphoscintigraphy in the study of lymphedema of the limbs].
After a brief review of the classical methodology and results of lymphoscintigraphy, the technique is considered in terms of an original kinetic study approach. Immediately after distal subcutaneous injection of a technetium colloid (rhenium sulfocolloid), 40 1-min serial images of the limbs are recorded followed 4 h after injection by recording of static images. The main abnormalities detected by scintigraphy concern the lymphatic vessels, nodes and interstitium. They reveal the presence of lymphedema and provide information about its mechanism, indicating, particularly in the case of primary lymphedema, whether there is predominant hyperplasia or hypoplasia in vessels or nodes. Synoptic study of the initial dynamic recording based on simple examination of serial images is difficult. Complementary data provided by activity curves determined from manually selected regions of interest (ROI'S) are of limited value since the ROI'S correspond to superimposed spatial structures. Two data-processing techniques--the condensed image (CI) and factorial analysis (FA)--were therefore applied to dynamic scintigraphic recordings in order to study lymphatic progress of the radiotracer in the legs. A complete dynamic series is described in two IC, one for each leg. The CI, obtained by mounting the 40 serial images in vertical strips 1 pixel in width, describes the spatial distribution of radioactivity along the leg during recording. Factorial analysis provides automatic extraction of pure kinetic components or factors from the dynamic series despite their spatial superposition. The factors are described by factorial curves and factorial images representing the spatial identity of the factor. Three-factor FA was applied successively to each leg.(ABSTRACT TRUNCATED AT 250 WORDS)
Service de Médecine Nucléaire et Ultrasons, Hôpital Trousseau, Tours.
F
F
Baulieu
L
L
Vaillant
J L
JL
Baulieu
V
V
Secchi
J
J
Barsotti
D001132:Arm; D006801:Humans; D007866:Leg; D008209:Lymphedema / Q000000981:diagnostic imaging* / Q000628:therapy; D011857:Radiographic Image Interpretation, Computer-Assisted; D011877:Radionuclide Imaging
Place actuelle de la lymphoscintigraphie dans l'étude d'un lymphoedème des membres.