[Value of exploring the deep lymphatic system of the lower limbs using lymphoscintigraphy. Preliminary study of 18 patients with arteritis]. / Intérêt de l'exploration du système lymphatique profond des membres inférieurs par lymphoscintigraphie. Etude préliminaire de 18 patients artéritiques.

ABSTRACT

Lymphoscintigraphy of lower limbs generally involves bilateral subcutaneous injection of a radioactive colloid into the first or second interdigital space only the superficial internal saphenous pathway is visualized in this way (superficial lymphoscintigraphy SL). However, the external saphenous and deep pathways can be explored by an external retromalleolar injection as demonstrated in radiology. Isotopic exploration of the external saphenous pathway and deep lymphatics (deep lymphoscintigraphy DL) was carried out in 18 patients with arteritis also investigated by SL. The study forms part of a prospective trial of edema developing after femoro-popliteal shunts. The deep lymphatics are correctly and easily visualized, and in about 20% of cases there exist anomalies of distribution of superficial or deep lymphatic flow, morphologic anomalies developing postoperatively in one pathway only, or in both pathways. DL is a simple, reliable method of investigation of deep lymphatics, and complete exploration of lymphatics of lower limbs should include both SL and DL.