Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations
Lymphoscintigraphy (LS), performed with technetium 99m—labeled antimony trisulfide colloid (Cadema Medical Products, Inc., Middletown, N.Y.), was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymp...
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| Veröffentlicht in: | J. Vasc. Surg.; (United States) 1989-05, Vol.9 (5), p.683-690 |
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| container_title | J. Vasc. Surg.; (United States) |
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| creator | Gloviczki, Peter Calcagno, David Schirger, Alexander Pairolero, Peter C. Cherry, Kenneth J. Hallett, John W. Wahner, Heinz W. |
| description | Lymphoscintigraphy (LS), performed with technetium 99m—labeled antimony trisulfide colloid (Cadema Medical Products, Inc., Middletown, N.Y.), was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymphedema, 48 had secondary lymphedema, and 21 patients had other causes of limb swelling. To determine the value of LS in surgical decision making, preoperative and postoperative LS of 16 patients who underwent surgical repair of the lymphatic abnormality were studied separately. Semiquantitative evaluation of the lymphatic drainage and visual interpretation of the image patterns were reliable to differentiate lymphedema from edemas of other origin (sensitivity: 92%, specificity: 100%). Although certain image patterns were characteristic of either primary or secondary lymphedema, LS could not consistently differentiate between the two types. Episodes of cellulitis in lymphedema clearly delayed lymph transport. LS was helpful in patient selection and follow-up after lymphatic surgery, but it did not prove patency of lymphovenous anastomoses. It was diagnostic in the evaluation of lymphangiectasia and was used to document successful surgical treatment of reflux of chyle. LS is safe and reliable and has no side effects. It should replace contrast lymphangiography in the routine evaluation of the swollen extremity. (
J Vasc Surg 1989;9:683–90.) |
| doi_str_mv | 10.1016/S0741-5214(89)70040-9 |
| format | Article |
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J Vasc Surg 1989;9:683–90.)</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/S0741-5214(89)70040-9</identifier><identifier>PMID: 2724456</identifier><identifier>CODEN: JVSUES</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>550601 - Medicine- Unsealed Radionuclides in Diagnostics ; Adolescent ; Adult ; Aged ; ANTIMONY ; Arm ; BETA DECAY RADIOISOTOPES ; BETA-MINUS DECAY RADIOISOTOPES ; Biological and medical sciences ; Blood and lymphatic vessels ; BODY ; BODY AREAS ; Cardiology. Vascular system ; Child ; Chronic Disease ; COLLOIDS ; COUNTING TECHNIQUES ; DIAGNOSIS ; Diagnosis, Differential ; DIAGNOSTIC TECHNIQUES ; DISEASES ; Diseases of the lymphatic vessels ; DISPERSIONS ; EDEMA ; ELEMENTS ; Evaluation Studies as Topic ; Female ; HEMIC DISEASES ; HOURS LIVING RADIOISOTOPES ; Humans ; INTERMEDIATE MASS NUCLEI ; ISOMERIC NUCLEI ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; Leg ; LIMBS ; LYMPHATIC SYSTEM ; Lymphatic System - surgery ; Lymphedema - diagnostic imaging ; Lymphedema - surgery ; Lymphoscintigraphy ; Male ; Medical sciences ; METALS ; Middle Aged ; NUCLEI ; ODD-EVEN NUCLEI ; PATHOLOGICAL CHANGES ; PATIENTS ; Postoperative Period ; RADIOISOTOPE SCANNING ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; SCINTISCANNING ; SENSITIVITY ANALYSIS ; SYMPTOMS ; Technetium ; TECHNETIUM 99 ; Technetium Compounds ; TECHNETIUM ISOTOPES ; YEARS LIVING RADIOISOTOPES</subject><ispartof>J. Vasc. Surg.; (United States), 1989-05, Vol.9 (5), p.683-690</ispartof><rights>1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter</rights><rights>1990 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3789-d6c1b92112357f2fbdf26b46016ac8e825f6cfa3743763a78b513033a0e079313</citedby><cites>FETCH-LOGICAL-c3789-d6c1b92112357f2fbdf26b46016ac8e825f6cfa3743763a78b513033a0e079313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0741-5214(89)70040-9$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,881,3536,23910,23911,25120,27904,27905,45975</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=6678558$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2724456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/5767031$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Gloviczki, Peter</creatorcontrib><creatorcontrib>Calcagno, David</creatorcontrib><creatorcontrib>Schirger, Alexander</creatorcontrib><creatorcontrib>Pairolero, Peter C.</creatorcontrib><creatorcontrib>Cherry, Kenneth J.</creatorcontrib><creatorcontrib>Hallett, John W.</creatorcontrib><creatorcontrib>Wahner, Heinz W.</creatorcontrib><creatorcontrib>Mayo Clinic, Rochester, MN (USA)</creatorcontrib><title>Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations</title><title>J. Vasc. Surg.; (United States)</title><addtitle>J Vasc Surg</addtitle><description>Lymphoscintigraphy (LS), performed with technetium 99m—labeled antimony trisulfide colloid (Cadema Medical Products, Inc., Middletown, N.Y.), was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymphedema, 48 had secondary lymphedema, and 21 patients had other causes of limb swelling. To determine the value of LS in surgical decision making, preoperative and postoperative LS of 16 patients who underwent surgical repair of the lymphatic abnormality were studied separately. Semiquantitative evaluation of the lymphatic drainage and visual interpretation of the image patterns were reliable to differentiate lymphedema from edemas of other origin (sensitivity: 92%, specificity: 100%). Although certain image patterns were characteristic of either primary or secondary lymphedema, LS could not consistently differentiate between the two types. Episodes of cellulitis in lymphedema clearly delayed lymph transport. LS was helpful in patient selection and follow-up after lymphatic surgery, but it did not prove patency of lymphovenous anastomoses. It was diagnostic in the evaluation of lymphangiectasia and was used to document successful surgical treatment of reflux of chyle. LS is safe and reliable and has no side effects. It should replace contrast lymphangiography in the routine evaluation of the swollen extremity. (
J Vasc Surg 1989;9:683–90.)</description><subject>550601 - Medicine- Unsealed Radionuclides in Diagnostics</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>ANTIMONY</subject><subject>Arm</subject><subject>BETA DECAY RADIOISOTOPES</subject><subject>BETA-MINUS DECAY RADIOISOTOPES</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>BODY</subject><subject>BODY AREAS</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Chronic Disease</subject><subject>COLLOIDS</subject><subject>COUNTING TECHNIQUES</subject><subject>DIAGNOSIS</subject><subject>Diagnosis, Differential</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DISEASES</subject><subject>Diseases of the lymphatic vessels</subject><subject>DISPERSIONS</subject><subject>EDEMA</subject><subject>ELEMENTS</subject><subject>Evaluation Studies as Topic</subject><subject>Female</subject><subject>HEMIC DISEASES</subject><subject>HOURS LIVING RADIOISOTOPES</subject><subject>Humans</subject><subject>INTERMEDIATE MASS NUCLEI</subject><subject>ISOMERIC NUCLEI</subject><subject>ISOMERIC TRANSITION ISOTOPES</subject><subject>ISOTOPES</subject><subject>Leg</subject><subject>LIMBS</subject><subject>LYMPHATIC SYSTEM</subject><subject>Lymphatic System - surgery</subject><subject>Lymphedema - diagnostic imaging</subject><subject>Lymphedema - surgery</subject><subject>Lymphoscintigraphy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>METALS</subject><subject>Middle Aged</subject><subject>NUCLEI</subject><subject>ODD-EVEN NUCLEI</subject><subject>PATHOLOGICAL CHANGES</subject><subject>PATIENTS</subject><subject>Postoperative Period</subject><subject>RADIOISOTOPE SCANNING</subject><subject>RADIOISOTOPES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>SCINTISCANNING</subject><subject>SENSITIVITY ANALYSIS</subject><subject>SYMPTOMS</subject><subject>Technetium</subject><subject>TECHNETIUM 99</subject><subject>Technetium Compounds</subject><subject>TECHNETIUM ISOTOPES</subject><subject>YEARS LIVING RADIOISOTOPES</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EKkPhJ1SKEEKwCNhx_OoGoao8pAoWwNpynGtilNjB9kw7_55kZjRbVl7c71yfcy5CVwS_I5jw9z-waEnNGtK-keqtwLjFtXqENgQrUXOJ1WO0OSNP0bOc_2BMCJPiAl00omlbxjfIfYvBh53JfgcV7My4NcXHUEVXlQGqfB_HEUIFDyXB5Mv-urp9mCF5CBZyde_LUBGFq3E_zUPM1ofifyczD94uGjP5cFiXn6MnzowZXpzeS_Tr0-3Pmy_13ffPX28-3tWWCqnqnlvSqYaQhjLhGtf1ruFdy5e8xkqQDXPcOkNFSwWnRsiOEYopNRiwUJTQS_TyuDfm4vXip4AdbAwBbNFMcIEP0OsjNKf4dwu56MlnC-NoAsRt1osTxVosFpAdQZtizgmcnpOfTNprgvV6BH04gl4b1lLpwxG0WnRXpw-23QT9WXVqfZm_Os1NtmZ0yQTr8xnjXEjG5IJ9OGKwNLbzkNZAa_G9T2uePvr_GPkHm8Sjkg</recordid><startdate>198905</startdate><enddate>198905</enddate><creator>Gloviczki, Peter</creator><creator>Calcagno, David</creator><creator>Schirger, Alexander</creator><creator>Pairolero, Peter C.</creator><creator>Cherry, Kenneth J.</creator><creator>Hallett, John W.</creator><creator>Wahner, Heinz W.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>198905</creationdate><title>Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations</title><author>Gloviczki, Peter ; Calcagno, David ; Schirger, Alexander ; Pairolero, Peter C. ; Cherry, Kenneth J. ; Hallett, John W. ; Wahner, Heinz W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3789-d6c1b92112357f2fbdf26b46016ac8e825f6cfa3743763a78b513033a0e079313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1989</creationdate><topic>550601 - Medicine- Unsealed Radionuclides in Diagnostics</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>ANTIMONY</topic><topic>Arm</topic><topic>BETA DECAY RADIOISOTOPES</topic><topic>BETA-MINUS DECAY RADIOISOTOPES</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>BODY</topic><topic>BODY AREAS</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Chronic Disease</topic><topic>COLLOIDS</topic><topic>COUNTING TECHNIQUES</topic><topic>DIAGNOSIS</topic><topic>Diagnosis, Differential</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DISEASES</topic><topic>Diseases of the lymphatic vessels</topic><topic>DISPERSIONS</topic><topic>EDEMA</topic><topic>ELEMENTS</topic><topic>Evaluation Studies as Topic</topic><topic>Female</topic><topic>HEMIC DISEASES</topic><topic>HOURS LIVING RADIOISOTOPES</topic><topic>Humans</topic><topic>INTERMEDIATE MASS NUCLEI</topic><topic>ISOMERIC NUCLEI</topic><topic>ISOMERIC TRANSITION ISOTOPES</topic><topic>ISOTOPES</topic><topic>Leg</topic><topic>LIMBS</topic><topic>LYMPHATIC SYSTEM</topic><topic>Lymphatic System - surgery</topic><topic>Lymphedema - diagnostic imaging</topic><topic>Lymphedema - surgery</topic><topic>Lymphoscintigraphy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>METALS</topic><topic>Middle Aged</topic><topic>NUCLEI</topic><topic>ODD-EVEN NUCLEI</topic><topic>PATHOLOGICAL CHANGES</topic><topic>PATIENTS</topic><topic>Postoperative Period</topic><topic>RADIOISOTOPE SCANNING</topic><topic>RADIOISOTOPES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>SCINTISCANNING</topic><topic>SENSITIVITY ANALYSIS</topic><topic>SYMPTOMS</topic><topic>Technetium</topic><topic>TECHNETIUM 99</topic><topic>Technetium Compounds</topic><topic>TECHNETIUM ISOTOPES</topic><topic>YEARS LIVING RADIOISOTOPES</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gloviczki, Peter</creatorcontrib><creatorcontrib>Calcagno, David</creatorcontrib><creatorcontrib>Schirger, Alexander</creatorcontrib><creatorcontrib>Pairolero, Peter C.</creatorcontrib><creatorcontrib>Cherry, Kenneth J.</creatorcontrib><creatorcontrib>Hallett, John W.</creatorcontrib><creatorcontrib>Wahner, Heinz W.</creatorcontrib><creatorcontrib>Mayo Clinic, Rochester, MN (USA)</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>J. Vasc. Surg.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gloviczki, Peter</au><au>Calcagno, David</au><au>Schirger, Alexander</au><au>Pairolero, Peter C.</au><au>Cherry, Kenneth J.</au><au>Hallett, John W.</au><au>Wahner, Heinz W.</au><aucorp>Mayo Clinic, Rochester, MN (USA)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations</atitle><jtitle>J. Vasc. Surg.; (United States)</jtitle><addtitle>J Vasc Surg</addtitle><date>1989-05</date><risdate>1989</risdate><volume>9</volume><issue>5</issue><spage>683</spage><epage>690</epage><pages>683-690</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Lymphoscintigraphy (LS), performed with technetium 99m—labeled antimony trisulfide colloid (Cadema Medical Products, Inc., Middletown, N.Y.), was used as a noninvasive diagnostic examination to evaluate the lymphatic circulation in 190 extremities of 115 patients. Forty-six patients had primary lymphedema, 48 had secondary lymphedema, and 21 patients had other causes of limb swelling. To determine the value of LS in surgical decision making, preoperative and postoperative LS of 16 patients who underwent surgical repair of the lymphatic abnormality were studied separately. Semiquantitative evaluation of the lymphatic drainage and visual interpretation of the image patterns were reliable to differentiate lymphedema from edemas of other origin (sensitivity: 92%, specificity: 100%). Although certain image patterns were characteristic of either primary or secondary lymphedema, LS could not consistently differentiate between the two types. Episodes of cellulitis in lymphedema clearly delayed lymph transport. LS was helpful in patient selection and follow-up after lymphatic surgery, but it did not prove patency of lymphovenous anastomoses. It was diagnostic in the evaluation of lymphangiectasia and was used to document successful surgical treatment of reflux of chyle. LS is safe and reliable and has no side effects. It should replace contrast lymphangiography in the routine evaluation of the swollen extremity. (
J Vasc Surg 1989;9:683–90.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>2724456</pmid><doi>10.1016/S0741-5214(89)70040-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0741-5214 |
| ispartof | J. Vasc. Surg.; (United States), 1989-05, Vol.9 (5), p.683-690 |
| issn | 0741-5214 1097-6809 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_78995407 |
| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | 550601 - Medicine- Unsealed Radionuclides in Diagnostics Adolescent Adult Aged ANTIMONY Arm BETA DECAY RADIOISOTOPES BETA-MINUS DECAY RADIOISOTOPES Biological and medical sciences Blood and lymphatic vessels BODY BODY AREAS Cardiology. Vascular system Child Chronic Disease COLLOIDS COUNTING TECHNIQUES DIAGNOSIS Diagnosis, Differential DIAGNOSTIC TECHNIQUES DISEASES Diseases of the lymphatic vessels DISPERSIONS EDEMA ELEMENTS Evaluation Studies as Topic Female HEMIC DISEASES HOURS LIVING RADIOISOTOPES Humans INTERMEDIATE MASS NUCLEI ISOMERIC NUCLEI ISOMERIC TRANSITION ISOTOPES ISOTOPES Leg LIMBS LYMPHATIC SYSTEM Lymphatic System - surgery Lymphedema - diagnostic imaging Lymphedema - surgery Lymphoscintigraphy Male Medical sciences METALS Middle Aged NUCLEI ODD-EVEN NUCLEI PATHOLOGICAL CHANGES PATIENTS Postoperative Period RADIOISOTOPE SCANNING RADIOISOTOPES RADIOLOGY AND NUCLEAR MEDICINE SCINTISCANNING SENSITIVITY ANALYSIS SYMPTOMS Technetium TECHNETIUM 99 Technetium Compounds TECHNETIUM ISOTOPES YEARS LIVING RADIOISOTOPES |
| title | Noninvasive evaluation of the swollen extremity: Experiences with 190 lymphoscintigraphic examinations |
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