早期乳腺癌前哨淋巴结活检术的临床应用

目的探讨应用前哨淋巴结活检（SLNB）技术预测腋窝淋巴结状态的准确性。方法应用同位素示踪法联合亚甲蓝染料示踪法对68名临床腋窝阴性的早期乳腺癌患者行前哨淋巴结活检术,然后行腋窝淋巴结清扫术（ALND）。对照前哨淋巴结情况与腋窝淋巴结状态的关系,分析SLNB的临床意义。结果68例患者中检出前哨淋巴结（SLN）66例,检出率为97．06％,共检出SLN192枚,平均每例2．91枚。66例中,34例SLN阴性患者中,2例为假阴性,假阴性率为5．88％。当SLN阴性时,SLNB预测腋窝淋巴结状态的准确率为94．12％。SLNB检测腋窝淋巴结转移情况的灵敏度为94．12％,特异度为94．12％,SLNB与ALND结果的一致率为77．27％。结论联合应用染料示踪法和同位素示踪法行SLNB具有较高的检出率,SLNB能较准确的预测腋窝淋巴结的转移情况。     

吲哚菁绿联合美蓝在乳腺癌腋窝前哨淋巴结活检的临床应用价值

目的:探讨吲哚菁绿（indocyanine green,ICG ）荧光导航法联合美蓝示踪法在乳腺癌腋窝前哨淋巴结活检（sentinel lymph node biopsy ,SLNB）中的临床应用价值。方法:收集2013年5 月至2014年4 月广东省汕头中心医院符合入组标准的89例早期乳腺癌患者。其中第一阶段,53例术中行ICG 联合美蓝注射,并利用淋巴荧光显像及美蓝示踪行前哨淋巴结活检术联合腋窝淋巴结清扫术（axillary lymph node dissection ALND ）;第二阶段,36例术中前哨淋巴结（sentinel lymphnode ,SLN ）冰冻病理阴性患者不再行腋窝淋巴结清扫。统计SLN 的检出成功率、准确率及假阴性率。结果:89例患者的SLN 检出成功率为96.6%（86/ 89）,第一阶段检出成功率为94.3%（50/ 53）、准确率98.0%（49/ 50）、假阴性率2.6%（1/ 38）,第二阶段检出成功率为100%（36/ 36）。 ICG 荧光导航法联合美蓝示踪法检出196 枚SLN 中荧光显示为179 枚,196 枚SLN 其中显示蓝染142 枚、未显示蓝染的54枚仅显示荧光。196 枚SLN 中有转移为45枚,5 枚仅显示荧光。22例患者SLN 转移,转移率为24.7%（22/ 89）,2 例患者的SLN 仅显示荧光而未蓝染。中位随访时间为25个月,未发现同侧区域淋巴结复发。结论:ICG 荧光导航法联合美蓝示踪法能够安全有效地应用于乳腺癌前哨淋巴结活检。      

早期宫颈癌前哨淋巴结检测的临床研究

[目的]探讨术中用^99mTc硫胶体与亚甲蓝联合和单一亚甲蓝两种方法在早期宫颈癌前哨淋巴结（SLN）检测中的临床价值。[方法]2004年8月至2006年12月治疗早期宫颈癌（临床Ⅰb、Ⅱa期）患者61例，分别采用^99mTc硫胶体作为示踪剂和亚甲蓝联合定位并切除SLN（Tc99＋dye组，27例）和单一亚甲蓝定位并切除SLN（dye组，34例）。然后行盆腔淋巴结清扫术及广泛性子宫切除术。SLN、NSLN分别进行病理检查。[结果]61例患者切除淋巴结共1647枚。48例检测到SLN，共检出SLN 141枚，平均每例2．9枚。Tc99＋dye组与dye组检出SLN分别为92．5％（25／27）、67．6％（23／34），Tc99＋dye联合组显著优于单一dye组（P〈0．01）。两组SLN分布依次分别为闭孔（63．2％、61．6％）、髂内（16．2％、19．2％）、髂外（10.3％、11．0％）、宫旁（5．9％、4．1％）和髂总（4.4％、4．1％），两组无显著性差异（P〉0．05）。盆腔淋巴结转移共13例（21.3％），共24枚，其中22枚为SLN，2枚为NSLN。1例SLN假阴性。[结论]对早期宫颈癌采用Tc99与亚甲蓝联合比单一亚甲蓝方法具有更高的SLN检出率；SLN主要分布于闭孔、髂内、髂外，但不能忽视宫旁SLN；SLN检测的适应证有待于进一步研究。     

早期宫颈癌前哨淋巴结检测的临床研究

[目的]探讨术中用^99mTc硫胶体与亚甲蓝联合和单一亚甲蓝两种方法在早期宫颈癌前哨淋巴结（SLN）检测中的临床价值。[方法]2004年8月至2006年12月治疗早期宫颈癌（临床Ⅰb、Ⅱa期）患者61例，分别采用^99mTc硫胶体作为示踪剂和亚甲蓝联合定位并切除SLN（Tc99＋dye组，27例）和单一亚甲蓝定位并切除SLN（dye组，34例）。然后行盆腔淋巴结清扫术及广泛性子宫切除术。SLN、NSLN分别进行病理检查。[结果]61例患者切除淋巴结共1647枚。48例检测到SLN，共检出SLN 141枚，平均每例2．9枚。Tc99＋dye组与dye组检出SLN分别为92．5％（25／27）、67．6％（23／34），Tc99＋dye联合组显著优于单一dye组（P〈0．01）。两组SLN分布依次分别为闭孔（63．2％、61．6％）、髂内（16．2％、19．2％）、髂外（10.3％、11．0％）、宫旁（5．9％、4．1％）和髂总（4.4％、4．1％），两组无显著性差异（P〉0．05）。盆腔淋巴结转移共13例（21.3％），共24枚，其中22枚为SLN，2枚为NSLN。1例SLN假阴性。[结论]对早期宫颈癌采用Tc99与亚甲蓝联合比单一亚甲蓝方法具有更高的SLN检出率；SLN主要分布于闭孔、髂内、髂外，但不能忽视宫旁SLN；SLN检测的适应证有待于进一步研究。     

前哨淋巴结检测在早期宫颈癌中的临床应用

背景与目的：前哨淋巴结（sentinel lymphnode,SLN）检测已经广泛应用于一些实体肿瘤的治疗方案设计中,特别是乳腺癌和体表恶性黑色素瘤。若SLN阴性,则可视为该淋巴区域无肿瘤转移。本研究的目的是探讨放射性核素定位法、活性染料定位法及二者联合法探测宫颈癌SLN和评价SLN对早期宫颈癌盆腔淋巴结转移状况的预测价值。方法：27例欲行广泛性子宫切除＋盆腔淋巴结清扫术的宫颈癌患者,术前16h注射^99mTc-右旋糖酐,进行SLN显像：手术时．注射亚甲蓝约4ml,寻找监染淋巴结;同时术中用1探针探测放射性热点。SLN全部被切除后,行广泛子宫切除＋盆腔淋巴结清扫术,所有切除的SLN及非SLN（non—sentinel lymph node,NSLN）分别送常规病理检查。结果：染料法、核素法、联合法对27例患者的SLN检出率分别为96.3%（26/27）、100%（27/27）,100%（27/27）;27例患者中染料法、核素法、联合法分别检出SLN61枚、69枚、70枚;核素法中,术前SPECT/CT融合显像较平面显像多检出4枚宫旁淋巴结。病理结果示7例患者有淋巴结转移,占25.9%（7/27）。SLN检测的敏感性,准确性、阴性预测值,假阴性率分别为85.7%（6/7）,96.3%（26/27）,95.2%（20/21）,14.3%（1/7）。结论：术前SPECT/CT三维断层显像检出SLN的敏感性优于平面显像,并且能够对SLN进行准确定位,联合应用放射性核素定位法和活性染料识别法提高了SLN检出的准确性;SLN的病理结果可以准确的预测早期宫颈癌患者盆腔淋巴结的病理状态。     

腹腔镜下吲哚菁绿示踪前哨淋巴结在保留生育功能宫颈癌手术中的应用

目的 探讨吲哚菁绿（indocyanine green,ICG）示踪前哨淋巴结在腹腔镜下保留生育功能宫颈癌手术中的应用效果并总结经验。方法 回顾性分析24例行腹腔镜下广泛宫颈切除+示踪前哨淋巴结（sentinel lymph node,SLN）切除宫颈癌患者的临床资料,所有患者均采用ICG示踪,进行前哨淋巴结活检（sentinel lymph node biopsy,SLNB）,分析显影情况、前哨淋巴结分布及数量。结果 24例患者均出现至少1个SLN显影,显影率为100%（24/24）,双侧显影率为93.8%（22/24）。不同示踪剂注射方法与术前是否行子宫锥切患者的SLN显影率差异无统计学意义（Ｐ＞0.05）。24例患者共切除前哨淋巴结210枚,平均8.75枚（3~19枚）,其中139枚SLN位于髂血管区域,占66.19%（139/210）。结论 在严格掌握指征和操作流程的情况下,ICG示踪前哨淋巴结可有效应用于腹腔镜下保留生育功能宫颈癌手术。     

甲状腺癌前哨淋巴结活检的应用观察研究

目的应用SLNB技术检测甲状腺癌前哨淋巴结,评价染料核素联合定位法的可行性及临床应用情况。方法应用SLNB技术检测在我科住院的46例甲状腺癌患者的前哨淋巴结,男11例,女35例;年龄25～75岁。Ⅰ期21例,Ⅱ期17例,Ⅲ期6例,Ⅳ期2例;有淋巴结转移31例,无淋巴结转移15例;甲状腺乳头状癌28例,滤泡腺癌17例,髓样癌1例。结果 46例甲状腺癌有43例检出SLN,其中SLN共检出65枚,其中1枚的23例,取出2枚的18例,取出3枚的2例。术中行冰冻检出有转移的SLN28枚,术后常规病理检出有转移的SLN31枚。SLN检出率93.4%（43/46）,敏感性90.3%（28/31）,假阴性率9.7%（3/31）。结论用核素、染料、r计数仪联合检测SLN,检出率较高（93.4%,43/46）,敏感性也较高（90.3%,28/31）,假阴性率9.7%（3/31）。与国内外报道接近,分别为66%～100%和80%～100%。因此用核素、染料、r计数仪联合检测SLN的方法可靠、准确性高,可以作为常规方法检测SLN。而根据SLN的结果决定是否行颈淋巴结清扫术,将有可能取代传统的颈淋巴结清扫原则。     

两种不同淋巴结示踪剂在腹腔镜下宫颈癌根治术中的应用对比

目的 探讨亚甲蓝和纳米炭混悬注射液两种不同淋巴结示踪剂在腹腔镜下宫颈癌根治术中的应用效果。方法 收集2015年至2016年50例被确诊为宫颈癌的患者,随机分为亚甲蓝组（n=25）和纳米炭混悬注射液组（n=25）。比较两种不同淋巴结示踪剂在宫颈癌根治术中对前哨淋巴结（SLN）的检出效果。结果 亚甲蓝组和纳米炭混悬注射液组对SLN的检出率均为100.0％。亚甲蓝组25例患者中有22例检出SLN,共48枚,平均2.2枚,识别率为880％, 5例发现淋巴结转移;纳米炭混悬注射液组25例患者中有23例检出SLN,共50枚,平均2.2枚,识别率为92.0％,4例发现淋巴结转移。两组患者均无明显不良反应。结论 亚甲蓝和纳米炭混悬注射液在腹腔镜下宫颈癌根治术中对SLN有较高的识别率和检出率,且安全性高,值得临床推广。     

早期宫颈癌前哨淋巴结中高危型HPV16/18 DNA表达的检测及临床意义

目的：探讨早期宫颈癌患者前哨淋巴结（SLN）中人乳头状瘤病毒（HPV）16/18 DNA表达检测对于微转移的临床意义。方法选取72例早期宫颈癌患者,予患者均行广泛性子宫切除加双侧盆腔淋巴结清扫术,术中采用染料法识别SLN的宫颈癌患者有46例,应用基因检测法（FQ-PCR）检测SLN中HPV16/18 DNA阳性表达情况,并分析其与各种临床病理因素的关系;对SLN病理阴性的33例患者进行长期随访,分析SLN中HPV16/18 DNA阳性与淋巴结转移的关系。结果46例宫颈癌患者SLN中HPV16/18 DNA阳性表达者共22例,其中13例淋巴结病理阳性患者中有10例阳性,而33例淋巴结病理阴性患者中仅12例阳性（P=0.013）;46例患者共检出前哨淋巴结102枚,均用FQ-PCR法检测HPV16/18 DNA,结果13例淋巴结病理阳性患者检出的37枚SLN中有29枚HPV16/18 DNA阳性,而33例淋巴结病理阴性患者检出的65枚SLN中仅有36枚阳性（P=0.033）;分析46例成功检出SLN的早期宫颈癌患者的临床资料,发现SLN中HPV16/18 DNA阳性表达仅与临床分期有关,具有统计学意义（P=0.034）;长期随访33例SLN病理阴性的患者,发现HPV16/18 DNA阳性的患者复发率高于HPV16/18 DNA阴性的患者,具有统计学意义（P=0.02）。结论检测宫颈癌SLN组织中HPV16/18 DNA表达可能是预测早期宫颈癌淋巴结微转移的可行方法。     

乳腔镜前哨淋巴结活检及腋窝淋巴结清扫的临床研究

目的：探讨乳腺癌在乳腔镜下行前哨淋巴结活检及腋窝淋巴结清扫的可行性。方法：通过亚甲蓝示踪对40例Ⅰ、Ⅱ期乳腺癌行乳腔镜前哨淋巴结活检（ESLNB）,然后行乳腔镜腋窝淋巴结清扫（EALND）,对获得的全部淋巴结行病理检查HE染色,确定前哨淋巴结（SLN）检出率、假阴性率等。结果：40例乳腺癌患者SLN检出率为97.44%（39/40）,准确率为94.87%（37/39）,灵敏度为94.74%（18/19）,假阴性率5.26%（1/19）;每例平均前哨淋巴结活检（SLNB）检出数目1-6枚,腋窝淋巴结清扫（ALND）检出数目10-29枚。结论：应用乳腔镜下前哨淋巴结活检和腋窝淋巴结清扫准确可行,美容效果好,并发症低,可对早期乳腺癌进行准确腋窝淋巴结分期。     

Sentinel lymph node biopsy in cervical and endometrial cancers: a feasibility study

The sentinel lymph node (SLN) biopsy has been proposed for the cancers of the uterus in order to optimize the diagnosis of lymphatic metastases and micrometastases in early stage tumors. Patients with early invasive cervical (n = 8) or endometrial (n = 15) cancers were enrolled. A lymphoscintigraphy was carried out before the intervention. Intraoperative SLN identification was performed with blue dye combined to a handheld gamma probe detection. Non-sentinel pelvic nodes were separately cleared out. SLNs were examined with frozen sections, permanent sections with hematoxylin-eosin staining and further serial sections with immunohistochemistry if negative. Six cervical cancer patients and 13 endometrial cancer patients had a positive lymphoscintigraphy, showing in 5 patients extra-iliac SLN(s). The intraoperative detection was successful in 6 cervical cancer patients and 14 endometrial cancer patients. The higher detection rate was obtained with the isotopic method. Most of the SLNs were ilio-obturator. Four endometrial cancer patients had a lymphatic spread, only involving the SLN in each case. No false negative SLN has been noted. SLN biopsy appears feasible in cervical and endometrial cancers. This procedure could improve the lymphatic evaluation of these cancers.     

Value of Sentinel Lymph Node (SLN) Mapping and Biopsy using Combined Intracervical Radiotracers and Blue Dye Injections for Endometrial Cancer

Background: Lymphadenectomy, as part of the initial surgical staging of patients with endometrial carcinoma, remains a controversial topic in gynecologic oncology. Sentinel lymph node (SLN) mapping has become a well-accepted procedure for melanomas and breast cancer; a number of investigators have begun to explore the utility and accuracy of this technique with regard to endometrial cancer. Aim: This study was conducted to evaluate SLN mapping of early stage endometrial cancer with blue dye in conjunction with a radioactive tracer. Subjects and methods: In this prospective cross-sectional study, patients with stage I and II endometrial cancer who were candidates for systemic lymph node dissection during surgery were enrolled, some underwent lymph node mapping and SLN biopsy using combined intra cervical radiotracer and blue dye injections and some applying only an intra cervical radiotracer. SLNs and other lymph nodes were sent for pathological assessment. Sensitivity, specificity, the positive predictive value, and the negative predictive value were calculated as predictive values for the radiotracer and blue dye. Results: Pre-operative lymph node mapping showed SLN in 29 out of 30 patients. Intra operations in 29/30 patients, SLNs were harvested by gamma probe; in 13 out of 19 patients SLNs were detected by blue dye. The median number of SLNs per patient was 3 and the total number of SLNs detected was 81. Four patients had positive pelvic lymph nodes. All of the positive nodes were SLNs. Using this technique (radiotracer and blue dye) an overall detection rate of 96.7%, an NPV of 100%, a sensitivity of 100% and a specificity of 3.85% were achieved. Conclusion: Results of SLN research for endometrial cancer are promising and make feasible the possibility of avoiding unnecessary aggressive surgical procedures in near future by advances in SLN mapping.     

Sentinel lymph node biopsy in patients with papillary thyroid carcinoma.

BACKGROUND: It remains controversial whether modified radical neck dissection (MRND) for patients with papillary thyroid carcinoma improves prognosis. However, it is highly probable that the incidence of local recurrence is reduced by lymph node dissection. Sentinel lymph node (SLN) biopsy (SLNB) for patients with melanoma and breast carcinoma has been validated as an accurate method for assessing lymph node status. The objective of this study was to determine the feasibility of SLNB for the evaluation of cervical lymph node status in patients with papillary thyroid carcinoma. METHODS: After injection of methylene blue around the tumor in 22 patients with papillary thyroid carcinoma, blue-stained lymph nodes were dissected as SLNs. After the SLNB, all patients also underwent subtotal thyroidectomy and MRND. SLNs and other lymph nodes were investigated with regard to their number, distribution, size, lymph node status, and ratio of metastatic area. RESULTS: There was concordance between the SLN findings and the regional lymph node status in 19 of 21 patients (90.5%; 7 patients had both positive SLN and regional lymph node results, and 12 patients had both negative SLN and regional lymph node results). Two patients had negative SLN results but, in the end, had positive nonsentinel lymph nodes (NSLNs). The overall reliability rate of SLNB was 86.3% (19 of 22 patients). The authors experienced no complications with the use of methylene blue for the detection of SLNs. CONCLUSIONS: SLNB using methylene blue is feasible technically and is safe, and the findings correlate with cervical lymph node status. Therefore, SLNB is a good technique for estimating the status of cervical lymph nodes in patients with papillary thyroid carcinoma.     

美蓝染色法鉴别哨兵淋巴结及其临床意义

目的：探讨美蓝染色法鉴别哨兵淋巴结（SLN）的可行性及其活检的临床意义。方法：采用美蓝染色法，对50例乳腺癌患者行腋窝淋巴作图，所得SLN和非哨兵淋巴结（NSLN）均行常规HE染色。阴性SLN再行连续切片及免疫组化检查，结果：50例患者中SLN阳性45例，SLN鉴别成功率为90．0％，45例中常规病检16例SLN阳性，对29例SLN阴性者采用连续切片和免疫组化检查发现7例（24．1％）有微转移，硝兵淋巴结活检的准确率，灵敏度和假阴性率分别为91．1％，85．7％和8．9％，结论：采用美蓝染色法能准确鉴别SLN，反映乳腺癌患者腋窝淋巴结状况，采用连续切片和免疫组化检查可检测出NSLN中的微转移灶，降低假阴性率。     

Sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy

BACKGROUND AND OBJECTIVES: Sentinel lymph node biopsy (SLNB) is an accurate method for axillary staging in patients with early breast cancer. The aim of this study was to evaluate the accuracy and the feasibility of SLNB in breast cancer patients who had received preoperative (neoadjuvant) chemotherapy. METHODS: Patients with advanced breast cancer stage II or III who were treated with neoadjuvant chemotherapy were included in the study. Sentinel lymph node (SLN) identification and biopsy was attempted and performed, and axillary lymph node dissection (ALND) was performed in the same surgical procedure after SLNB. The histopathologic examination of the SLNs and the dissected axillary lymph nodes was performed and nodal status was compared. RESULTS: Thirty patients were included in the study. After peritumoural injection of technetium-99m labelled human albumin and subareolar subcutaneous injection of blue dye, the SLNs could be identified in 26/30 patients (identification rate 86.7%). In 4/30 patients (13.3%) SLNs could not be identified. In 25/26 patients (96.2%) SLNs accurately predicted the axillary status. Eleven patients had negative SLNs and negative nodes in ALND. Six patients had positive SLNs and positive nodes in ALND. In eight patients SLNs only were positive and nodes in ALND were negative. One patient had a false-negative SLNB, calculating a false-negative rate of 6.7% (1/15). CONCLUSIONS: SLNB is a well introduced technique for axillary staging in patients with early breast cancer. The accuracy of SLNB after neoadjuvant chemotherapy is similar to patients with primary surgery. SLNB could be an alternative to ALND in a subgroup of patients after neoadjuvant chemotherapy, and therefore could reduce morbidity due to surgery in those patients. Due to small numbers of patients, further evaluation in this subset of patients is required.     

早期宫颈癌盆腔淋巴结转移的分布

目的 探讨早期宫颈癌患者盆腔淋巴结转移的规律,提出宫颈癌盆腔淋巴结三级分站的可行性.方法 选取196例行广泛子宫切除和盆腔淋巴清扫术的Ⅰa2～Ⅱa期宫颈癌患者为研究对象,术前在宫颈肿瘤周围黏膜下3、6、9、12点处分别注射99mTc-硫胶体0.5ml,术后将清扫的盆腔淋巴结用闾讲庖墙刑逋馓讲?确定放射活性计数比同侧淋巴结升高5倍者为前哨淋巴结,将切除的盆腔淋巴结连续切片行HE染色进行病理检测.结果 共检出41例患者的83枚转移盆腔淋巴结,其中宫旁和闭孔淋巴结转移65枚,髂内外淋巴结转移17枚,髂总淋巴结转移1枚.22例宫旁淋巴结转移患者中,同时伴有髂内淋巴结转移者3例,髂外淋巴结转移者5例,髂内和髂外淋巴结均转移者1例.19例闭孔淋巴结转移患者中,同时伴有髂内淋巴结转移者3例,髂外淋巴结转移者4例.x2检验显示,宫旁和(或)闭孔淋巴结转移与盆腔其他区域淋巴结的转移呈正相关.共检出转移前哨淋巴结81枚,其中宫旁和闭孔前哨淋巴结转移64枚,髂内外前哨淋巴结转移17枚.宫旁和(或)闭孔淋巴结转移组与非转移组比较,患者的1和3年生存率差异无统计学意义,但非转移组患者的5年生存率(93.2%)明显高于转移组(65.1%).结论 宫颈癌患者的盆腔淋巴结转移分为三站是可行的,第1站为宫旁和闭孔区域淋巴结,第2站为髂内和髂外淋巴结,第3站为髂总和腹股沟深淋巴结,可根据转移情况合理地制定患者的治疗方案.     

纳米碳在子宫内膜癌前哨淋巴结检测中的应用

目的:探讨纳米碳在子宫内膜癌前哨淋巴结检测中的可行性及应用价值。方法:选择25例经手术治疗的子宫内膜癌患者,术中于子宫前壁、后壁、宫底两侧共4点处注射纳米碳混悬液,识别黑染的淋巴结,并记录前哨淋巴结相关信息,淋巴结分开单独送病理检查行HE染色。结果:25例子宫内膜癌患者均出现子宫浆膜面黑染,前哨淋巴结检出率为84%（21/25）,共计114枚,其中盆腔双侧检出率为81%,盆腔一侧检出率为19%。3例患者发生淋巴结转移,均为SLN转移。结论:纳米碳作子宫内膜癌前哨淋巴结的示踪剂具有可行性,对于子宫内膜癌淋巴结转移判断有一定的临床应用价值。     

Interstitial magnetic resonance lymphography is an effective diagnostic tool for the detection of lymph node metastases in patients with cervical cancer

ABSTRACT: BACKGROUND: The aim of the present study was to determine the feasibility of detecting sentinel lymph node (SLN) metastases using interstitial magnetic resonance (MR) lymphography in patients with cervical cancer. MR data were compared to pathological results from the lymph nodes excised during surgery. METHODS: Twenty-eight patients with cervical cancer were enrolled and studied from January 2006 to December 2010. All patients underwent interstitial MR lymphography to determine the presence of sentinel lymph nodes and visualize lymphatic vessel drainage in the pelvis. Radical hysterectomy and excision of pelvic lymph nodes was performed according to their lesion grade. Gadodiamide was injected either intradermally into the bipedal toe web, into the labia majora or into the cervical tissue. MR results were compared with pathological reports. RESULTS: In 28 patients, lymphatic vessel drainage and lymph node groups were clearly visualized. Of these, 5 were MR lymphography positive and 23 were MR lymphography negative. Six had pathologically proven metastasis, five had true positives and 1 had a false negative in the obturator lymph node. CONCLUSIONS: Interstitial MR lymphography can be used to determine the extent and shape of pelvic lymphatic vessel drainage and lymph node metastases in patients with cervical cancer.