应用近红外荧光淋巴显像诊断正常肢体及淋巴水肿

摘要

目的 应用近红外荧光(NIRF)显像评估正常肢体及淋巴水肿肢体的淋巴结构及功能.资料与方法 肢体皮内注射吲哚青绿后,行动态NIRF淋巴显像,观测肢体的淋巴管结构及回流功能.结果 正常肢体可见规则的淋巴管状结构及"弹丸"式淋巴回流,淋巴管外无NIRF显像剂滞留.淋巴水肿依据显像表现分为4级,诊断要点包括:淋巴管外染料聚集、弯曲的侧支淋巴管、毛细淋巴管网显影,淋巴回流减慢及逆流.结论 NIRF淋巴显像能正确地诊断肢体淋巴水肿,具有较大的临床应用潜力.%Purpose To evaluate lymphatic structure and function of the limbs in normal human subjects and lymphedema patients using near infrared fluorescence (NIRF) lymphography.Materials and Methods A serial of dynamic NIRF imagines were acquired after intradermal injection of indocyanine green to observe the lymphatic structure and function.Results Well defined lymphatic structures with propulsive dye transport were revealed in normal limbs without extravascular dye accumulation.Lymphedema was categorized into four degrees according to images property which including extravascular dye accumulation, tortuous lymphatic vessels, networks of fluorescent lymphatic capillaries, low lymph velocity, and even lymph reflex.Conclusion NIRF lymphography can accurately diagnose the limb lymphedema, and illustrate the potential great clinical application.