Lymphedema evaluation using noninvasive 3T MR lymphangiography.
J Magn Reson Imaging
; 46(5): 1349-1360, 2017 11.
Article
em En
| MEDLINE
| ID: mdl-28245075
ABSTRACT
PURPOSE:
To exploit the long 3.0T relaxation times and low flow velocity of lymphatic fluid to develop a noninvasive 3.0T lymphangiography sequence and evaluate its relevance in patients with lymphedema. MATERIALS ANDMETHODS:
A 3.0T turbo-spin-echo (TSE) pulse train with long echo time (TEeffective = 600 msec; shot-duration = 13.2 msec) and TSE-factor (TSE-factor = 90) was developed and signal evolution simulated. The method was evaluated in healthy adults (n = 11) and patients with unilateral breast cancer treatment-related lymphedema (BCRL; n = 25), with a subgroup (n = 5) of BCRL participants scanned before and after manual lymphatic drainage (MLD) therapy. Maximal lymphatic vessel cross-sectional area, signal-to-noise-ratio (SNR), and results from a five-point categorical scoring system were recorded. Nonparametric tests were applied to evaluate study parameter differences between controls and patients, as well as between affected and contralateral sides in patients (significance criteria two-sided P < 0.05).RESULTS:
Patient volunteers demonstrated larger lymphatic cross-sectional areas in the affected (arm = 12.9 ± 6.3 mm2 ; torso = 17.2 ± 15.6 mm2 ) vs. contralateral (arm = 9.4 ± 3.9 mm2 ; torso = 9.1 ± 4.6 mm2 ) side; this difference was significant both for the arm (P = 0.014) and torso (P = 0.025). Affected (arm P = 0.010; torso P = 0.016) but not contralateral (arm P = 0.42; torso P = 0.71) vessel areas were significantly elevated compared with control values. Lymphatic cross-sectional areas reduced following MLD on the affected side (pre-MLD arm = 8.8 ± 1.8 mm2 ; torso = 31.4 ± 26.0 mm2 ; post-MLD arm = 6.6 ± 1.8 mm2 ; torso = 23.1 ± 24.3 mm2 ). This change was significant in the torso (P = 0.036). The categorical scoring was found to be less specific for detecting lateralizing disease compared to lymphatic-vessel areas.CONCLUSION:
A 3.0T lymphangiography sequence is proposed, which allows for upper extremity lymph stasis to be detected in â¼10 minutes without exogenous contrast agents. LEVEL OF EVIDENCE 1 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2017;461349-1360.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Imageamento por Ressonância Magnética
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Linfografia
/
Linfedema
Tipo de estudo:
Guideline
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
J Magn Reson Imaging
Assunto da revista:
DIAGNOSTICO POR IMAGEM
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos