Functional anatomy of the lymphatics draining the skin: a detailed statistical analysis
Relatively little is known about the functional anatomy of the lymphatic vessels draining the skin. To address this issue, we previously created a three‐dimensional computer model of skin lymphatic drainage, using melanoma lymphoscintigraphy (LS) data from 5232 patients. In this study we sought to e...
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description | Relatively little is known about the functional anatomy of the lymphatic vessels draining the skin. To address this issue, we previously created a three‐dimensional computer model of skin lymphatic drainage, using melanoma lymphoscintigraphy (LS) data from 5232 patients. In this study we sought to extend our model by performing a detailed statistical analysis of the mapped LS data to characterize the functional anatomy of the superficial lymphatics without any a‐priori spatial bias. We investigated the commonly held assumption that lymphatic drainage is symmetric between the two sides of the body. Results indicated that, with the exception of the lower anterior torso, posterior leg and a small section of the posterior torso, most skin regions with sufficient data showed symmetric drainage. LS data from each symmetric skin region were then reflected to the opposite side of the body to provide an increased LS dataset for subsequent analysis. Cluster analysis was then applied to this reflected LS dataset to group regions of skin that drained in a similar manner. Results defined nine large clusters of skin, largely draining to the dominant axillary, groin, cervical level II and preauricular node fields. Each of the four axillary and groin node fields defined large clusters of skin on the torso, dividing it into regions similar to the historical ‘Sappey’s lines’, although a fifth region of highly ambiguous drainage was also shown in the anterior and posterior center of the torso. Collectively, these results provide important new insights into skin lymphatic drainage, both improving and quantifying our understanding of functional lymphatic anatomy. |
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Rod ; O’Sullivan, Michael J. ; Uren, Roger F. ; Thompson, John F. ; Smith, Nicolas P.</creator><creatorcontrib>Reynolds, Hayley M. ; Walker, Cameron G. ; Dunbar, P. Rod ; O’Sullivan, Michael J. ; Uren, Roger F. ; Thompson, John F. ; Smith, Nicolas P.</creatorcontrib><description>Relatively little is known about the functional anatomy of the lymphatic vessels draining the skin. To address this issue, we previously created a three‐dimensional computer model of skin lymphatic drainage, using melanoma lymphoscintigraphy (LS) data from 5232 patients. In this study we sought to extend our model by performing a detailed statistical analysis of the mapped LS data to characterize the functional anatomy of the superficial lymphatics without any a‐priori spatial bias. We investigated the commonly held assumption that lymphatic drainage is symmetric between the two sides of the body. Results indicated that, with the exception of the lower anterior torso, posterior leg and a small section of the posterior torso, most skin regions with sufficient data showed symmetric drainage. LS data from each symmetric skin region were then reflected to the opposite side of the body to provide an increased LS dataset for subsequent analysis. Cluster analysis was then applied to this reflected LS dataset to group regions of skin that drained in a similar manner. Results defined nine large clusters of skin, largely draining to the dominant axillary, groin, cervical level II and preauricular node fields. Each of the four axillary and groin node fields defined large clusters of skin on the torso, dividing it into regions similar to the historical ‘Sappey’s lines’, although a fifth region of highly ambiguous drainage was also shown in the anterior and posterior center of the torso. Collectively, these results provide important new insights into skin lymphatic drainage, both improving and quantifying our understanding of functional lymphatic anatomy.</description><identifier>ISSN: 0021-8782</identifier><identifier>EISSN: 1469-7580</identifier><identifier>DOI: 10.1111/j.1469-7580.2009.01183.x</identifier><identifier>PMID: 20070428</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>computer modeling ; Computer Simulation ; History, 19th Century ; History, 20th Century ; History, 21st Century ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Lymph Nodes - anatomy & histology ; Lymph Nodes - physiology ; lymphatic anatomy ; lymphatic drainage ; Lymphatic System - anatomy & histology ; Lymphatic System - physiology ; Lymphatic Vessels - anatomy & histology ; Lymphatic Vessels - physiology ; Lymphography ; Original ; Sappey’s lines ; skin ; Skin - anatomy & histology ; Statistics as Topic ; symmetry</subject><ispartof>Journal of anatomy, 2010-03, Vol.216 (3), p.344-355</ispartof><rights>2010 The Authors. Journal compilation © 2010 Anatomical Society of Great Britain and Ireland</rights><rights>Journal compilation © 2010 Anatomical Society of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4733-82424b6e2b051d676144eba54760bc1670cf0efd1cb513c45e2dcfda50a3db8a3</citedby><cites>FETCH-LOGICAL-c4733-82424b6e2b051d676144eba54760bc1670cf0efd1cb513c45e2dcfda50a3db8a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829393/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829393/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,1433,27924,27925,45574,45575,46409,46833,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20070428$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reynolds, Hayley M.</creatorcontrib><creatorcontrib>Walker, Cameron G.</creatorcontrib><creatorcontrib>Dunbar, P. Rod</creatorcontrib><creatorcontrib>O’Sullivan, Michael J.</creatorcontrib><creatorcontrib>Uren, Roger F.</creatorcontrib><creatorcontrib>Thompson, John F.</creatorcontrib><creatorcontrib>Smith, Nicolas P.</creatorcontrib><title>Functional anatomy of the lymphatics draining the skin: a detailed statistical analysis</title><title>Journal of anatomy</title><addtitle>J Anat</addtitle><description>Relatively little is known about the functional anatomy of the lymphatic vessels draining the skin. To address this issue, we previously created a three‐dimensional computer model of skin lymphatic drainage, using melanoma lymphoscintigraphy (LS) data from 5232 patients. In this study we sought to extend our model by performing a detailed statistical analysis of the mapped LS data to characterize the functional anatomy of the superficial lymphatics without any a‐priori spatial bias. We investigated the commonly held assumption that lymphatic drainage is symmetric between the two sides of the body. Results indicated that, with the exception of the lower anterior torso, posterior leg and a small section of the posterior torso, most skin regions with sufficient data showed symmetric drainage. LS data from each symmetric skin region were then reflected to the opposite side of the body to provide an increased LS dataset for subsequent analysis. Cluster analysis was then applied to this reflected LS dataset to group regions of skin that drained in a similar manner. Results defined nine large clusters of skin, largely draining to the dominant axillary, groin, cervical level II and preauricular node fields. Each of the four axillary and groin node fields defined large clusters of skin on the torso, dividing it into regions similar to the historical ‘Sappey’s lines’, although a fifth region of highly ambiguous drainage was also shown in the anterior and posterior center of the torso. Collectively, these results provide important new insights into skin lymphatic drainage, both improving and quantifying our understanding of functional lymphatic anatomy.</description><subject>computer modeling</subject><subject>Computer Simulation</subject><subject>History, 19th Century</subject><subject>History, 20th Century</subject><subject>History, 21st Century</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Imaging, Three-Dimensional</subject><subject>Lymph Nodes - anatomy & histology</subject><subject>Lymph Nodes - physiology</subject><subject>lymphatic anatomy</subject><subject>lymphatic drainage</subject><subject>Lymphatic System - anatomy & histology</subject><subject>Lymphatic System - physiology</subject><subject>Lymphatic Vessels - anatomy & histology</subject><subject>Lymphatic Vessels - physiology</subject><subject>Lymphography</subject><subject>Original</subject><subject>Sappey’s lines</subject><subject>skin</subject><subject>Skin - anatomy & histology</subject><subject>Statistics as Topic</subject><subject>symmetry</subject><issn>0021-8782</issn><issn>1469-7580</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV9P2zAUxa2JaRS2r4D8xlPC9Z8kDhJIVbUOpkq8bNqj5dgOdUmcEqfQfPs5lFXb2_xiy_d3z706ByFMICXxXG1SwvMyKTIBKQUoUyBEsHT_Ac2OhRM0A6AkEYWgp-gshA0AYVDyT-g09hTAqZihX8ud14PrvGqw8mro2hF3NR7WFjdju12rwemATa-cd_7x7T88OX-NFTZ2UK6xBochUiGCB41mDC58Rh9r1QT75f0-Rz-XX38s7pLVw7f7xXyVaF4wlgjKKa9ySyvIiMmLnHBuK5XxIodKk7wAXYOtDdFVRpjmmaVG10ZloJiphGLn6Pagu91VrTXa-qFXjdz2rlX9KDvl5L8V79bysXuRVNCSlSwKXL4L9N3zzoZBti5o2zTK224XZNwyKwXL80iKA6n7LoTe1scpBOQUi9zIyX05uS-nWORbLHIfWy_-3vLY-CeHCNwcgNfo6PjfwvL7w3x6sd9Pbp4i</recordid><startdate>201003</startdate><enddate>201003</enddate><creator>Reynolds, Hayley M.</creator><creator>Walker, Cameron G.</creator><creator>Dunbar, P. 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Rod</au><au>O’Sullivan, Michael J.</au><au>Uren, Roger F.</au><au>Thompson, John F.</au><au>Smith, Nicolas P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional anatomy of the lymphatics draining the skin: a detailed statistical analysis</atitle><jtitle>Journal of anatomy</jtitle><addtitle>J Anat</addtitle><date>2010-03</date><risdate>2010</risdate><volume>216</volume><issue>3</issue><spage>344</spage><epage>355</epage><pages>344-355</pages><issn>0021-8782</issn><eissn>1469-7580</eissn><abstract>Relatively little is known about the functional anatomy of the lymphatic vessels draining the skin. To address this issue, we previously created a three‐dimensional computer model of skin lymphatic drainage, using melanoma lymphoscintigraphy (LS) data from 5232 patients. In this study we sought to extend our model by performing a detailed statistical analysis of the mapped LS data to characterize the functional anatomy of the superficial lymphatics without any a‐priori spatial bias. We investigated the commonly held assumption that lymphatic drainage is symmetric between the two sides of the body. Results indicated that, with the exception of the lower anterior torso, posterior leg and a small section of the posterior torso, most skin regions with sufficient data showed symmetric drainage. LS data from each symmetric skin region were then reflected to the opposite side of the body to provide an increased LS dataset for subsequent analysis. Cluster analysis was then applied to this reflected LS dataset to group regions of skin that drained in a similar manner. Results defined nine large clusters of skin, largely draining to the dominant axillary, groin, cervical level II and preauricular node fields. Each of the four axillary and groin node fields defined large clusters of skin on the torso, dividing it into regions similar to the historical ‘Sappey’s lines’, although a fifth region of highly ambiguous drainage was also shown in the anterior and posterior center of the torso. Collectively, these results provide important new insights into skin lymphatic drainage, both improving and quantifying our understanding of functional lymphatic anatomy.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20070428</pmid><doi>10.1111/j.1469-7580.2009.01183.x</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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subjects | computer modeling Computer Simulation History, 19th Century History, 20th Century History, 21st Century Humans Image Processing, Computer-Assisted Imaging, Three-Dimensional Lymph Nodes - anatomy & histology Lymph Nodes - physiology lymphatic anatomy lymphatic drainage Lymphatic System - anatomy & histology Lymphatic System - physiology Lymphatic Vessels - anatomy & histology Lymphatic Vessels - physiology Lymphography Original Sappey’s lines skin Skin - anatomy & histology Statistics as Topic symmetry |
title | Functional anatomy of the lymphatics draining the skin: a detailed statistical analysis |
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