title: [MR lymphangiography for assessment of focal dermal backflow for presurgical work-up in patients with peripheral lymphoedema].
abstract: BACKGROUND
  MR lymphangiography might provide valuable morphological information in the diagnosis of peripheral lymphedema in addition to lymphoscintigraphy. Even patients with focal dermal backflow can benefit from surgical intervention. The purpose of this study was to assess the feasibility of MR-Lymphangiography for assessment of focal dermal backflow for pre-surgical work-up. PATIENTS/MATERIALS & METHODS: 50 patients with peripheral lymphedema were included in this study. Patients showing focal dermal backflow in MR-Lymphangiography were reviewed and analyzed separately. The MR findings were correlated to lymphoscintigraphy. Concordance of the 2 modalities regarding existence and distribution of dermal backflow were examined. Furthermore the feeding vessels of the dermal backflow were assessed and visualized.
  
  
  RESULTS
  Dermal backflow was diagnosed with MR lymphangiography in 13 patients. Dermal backflow was confirmed by lymphoscintigraphy in 12 patients (92.3%). The feeding vessels of the dermal backflow configuration could be visualized in 9 patients (69.2%) and could be visualized with 3-dimensional reconstructions. The latter is not possible with lymphoscintigraphy.
  
  
  CONCLUSIONS
  MR lymphangiography provides important supplementary diagnostic information in patients with peripheral lymphedema additional to lymphoscintigraphy. Particularly in patients with focal dermal backflow and intended surgery, MR lymphangiography holds high potential for pre-surgical work-up.
authors.affiliation: Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377 München. frederik.strobl@med.lmu.de
authors.forename: F F
authors.initials: FF
authors.lastname: Strobl
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Wallmichrath
authors.forename: R
authors.initials: R
authors.lastname: Baumeister
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.forename: M
authors.initials: M
authors.lastname: Notohamiprodjo
mesh_terms: D000293:Adolescent; D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007866:Leg / Q000503:physiopathology / Q000601:surgery; D008196:Lymph / Q000502:physiology*; D008209:Lymphedema / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D008220:Lymphography / Q000379:methods*; D061305:Lymphoscintigraphy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D040521:Subcutaneous Tissue / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA