WordNet

roentgenographic examination of lymph nodes and lymph vessels after injection of a radiopaque contrast medium; produces a lymphangiogram (同)lymphography

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/07/08 19:09:12」(JST)

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Lymphography is a medical imaging technique in which a radiocontrast agent is injected, and then an X-ray picture is taken to visualize structures of the lymphatic system, including lymph nodes, lymph ducts, lymphatic tissues, lymph capillaries and lymph vessels. Lymphangiography is the same procedure, used only to visualize the lymph vessels. The X-ray film or image of the vessels and nodes is called a lymphogram or a lymphangiogram.

Radiographs can be taken after injection of a radiopaque contrast medium into small lymphatic vessels (these are made visible by prior subcutaneous injection of patent blue dye). The resulting lymphogram is used to find the locations of large vessels and nodes, and to identify sites of blockage in lymphatic drainage.

Lymph nodes can also be detected via radionuclide imaging after injection of radioactive colloids. Macrophages phagocytose these foreign bodies and sequester in the nodes.

Procedure

A needle or catheter is inserted into a lymphatic channel in either the foot or arm, and a contrast medium is injected into the body at a very slow rate (approximately 60 to 90 minutes for all the contrast medium to be injected).
A fluoroscope is used to follow the dye as it spreads through the lymphatic system through the legs, into the groin, and along the back of the abdominal cavity.
Once the contrast medium is injected, the catheter is removed, and the incisions are stitched and bandaged. X-rays are taken of the legs, pelvis, abdomen, and chest areas. The next day, another set of X-rays may be taken.
If a site of cancer (breast or melanoma) is being studied to evaluate spreading, a mixture of blue dye and a radioactive tracer is injected next to the mass. Special cameras detect the spread of tracer along lymph channels to outlying nodes.
A surgeon will then use the visible blue dye or radioactivity within nodes to guide biopsy within adjacent tissues (such as the arm pit for breast cancer) to determine possible routes of cancer spread.

Use

This test is not used as often as it once was, because of the adoption of CT scan and the PET scan technologies.

Name

The name comes from the Greek words lymph (νυμφε), "water nymph", and graphien, "to write or record".

References

Guermazi A, Brice P, Hennequin C, Sarfati E (2003). "Lymphography: an old technique retains its usefulness". Radiographics 23 (6): 1541–58; discussion 1559–60. doi:10.1148/rg.236035704. PMID 14615563. Full text

External links

About lymphangiogram (National Library of Medicine and the National Institutes of Health)

UpToDate Contents

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1. 乳糜胸症の病因、臨床像、および診断 etiology clinical presentation and diagnosis of chylothorax
2. リンパ管炎 lymphangitis
3. リンパ管フィラリア症の診断、治療、および予防 diagnosis treatment and prevention of lymphatic filariasis
4. 乳糜胸症のマネージメント management of chylothorax
5. 成人における末梢リンパ節腫大の評価 evaluation of peripheral lymphadenopathy in adults

English Journal

Integrated lymphography using fluorescence imaging and magnetic resonance imaging in intact mice.

Inoue Y, Masutani Y, Kiryu S, Haishi T, Yoshikawa K, Watanabe M, Shimada M, Ohtomo K.AbstractWe assessed lymph drainage in living mice by an integrated imaging method using fluorescence imaging (FLI) and magnetic resonance imaging (MRI). Mice were subcutaneously injected with quantum dots and gadofluorine 8 into the right rear footpad. They were fixed on a transparent flat plate and underwent FLI and MRI successively. Small markers were attached to the mouse surface for spatial coregistration, and image fusion of FLIs and MRIs was performed. Two-dimensional fluorescence reflectance imaging was used for FLI. FLI and MRI provided generally consistent results and demonstrated lymphatic flow to the popliteal, sacral, and iliac lymph nodes in most mice and to the renal, inguinal, and lumbar-aortic lymph nodes in some mice. On the fusion images, the locations of the lymph nodes in the mouse trunk were in good agreement between FLI and MRI, indicating successful spatial registration even for the deep structures. The popliteal node tended to be visualized a little farther caudally in FLI than in MRI, presumably because the overlying tissues were thicker in the cranial portion. Integrated FLI/MRI lymphography with image fusion appears to be a useful tool for analysis of the murine lymphatic system.
Molecular imaging.Mol Imaging.2011 Oct 1;10(5):317-26.
We assessed lymph drainage in living mice by an integrated imaging method using fluorescence imaging (FLI) and magnetic resonance imaging (MRI). Mice were subcutaneously injected with quantum dots and gadofluorine 8 into the right rear footpad. They were fixed on a transparent flat plate and underwe
PMID 21914429

The earliest finding of indocyanine green lymphography in asymptomatic limbs of lower extremity lymphedema patients secondary to cancer treatment: the modified dermal backflow stage and concept of subclinical lymphedema.

Yamamoto T, Matsuda N, Doi K, Oshima A, Yoshimatsu H, Todokoro T, Ogata F, Mihara M, Narushima M, Iida T, Koshima I.SourceTokyo, Japan From the Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo.
Plastic and reconstructive surgery.Plast Reconstr Surg.2011 Oct;128(4):314e-21e.
BACKGROUND: : Early diagnosis and treatment are as important for management of secondary lymphedema following cancer treatment as in primary cancer treatment. Indocyanine green lymphography is the modality of choice for routine follow-up evaluation of patients at high risk of developing lymphedema a
PMID 21921744

Japanese Journal

皮弁移植後のリンパ管再生に関する検討

佐藤卓士,木股敬裕,杉山成史,山田潔,徳山英二郎,長谷川健二郎,難波祐三郎,青雅一
日本マイクロサージャリー学会会誌 = Journal of Japanese Society of Reconstructive Microsurgery 23(1), 64-69, 2010-03-01
NAID 10027462179

胸管の走行変異を認めた肺癌術後乳糜胸の1例

石橋史博,安川朋久,塩田広宣,宗知子,由佐俊和
日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery 24(1), 39-43, 2010-01-15
症例は65歳の男性で，右肺癌に対し，右肺上葉切除＋ND2aを施行した．術後第1病日，昼食摂取後に胸水の白濁を認め乳糜胸と診断した．中鎖脂肪酸のみによる脂肪制限食を開始し，OK-432による胸膜癒着療法も行ったが，胸水の減量を認めなかった．第25病日にリンパ管造影を施行し，胸管が気管分岐部付近より走行を変えて右静脈角に向かうという走行変異と，胸腔頂付近での胸管の断絶およびリピオドールの漏出を確認した …
NAID 10025954426