梗阻性淋巴水肿淋巴动力学异常的实验观察

目的探讨间质MR淋巴造影对评价淋巴动力学的价值. 材料与方法用改良的Danese手术方法在13只新西兰大白兔后肢一侧形成淋巴水肿模型,另一侧作为对照.在每只大白兔双侧后肢足背部趾蹼处注射0.2 ml欧乃影,按摩注射部位30 s.分别于对比剂注射前后进行三维MR淋巴造影及延迟淋巴造影成像.测量不同延迟时间引流区域淋巴结的信号强度,绘制时间-信号强度曲线. 结果对照侧窝淋巴结、腹股沟淋巴结、髂淋巴结/后腹膜淋巴结分别于注射对比剂10、20、30 min后信号强度达到峰值.实验侧在淋巴水肿的不同时期出现不同程度的引流远端腹股沟及髂窝淋巴结信号强度峰值高度及峰值时间下降和延迟. 结论间质MR淋巴造影可以定量地评价引流区域淋巴动力学的状况.

The Experimental Study of Abnormal Lymphatic Dynamics in Obstructive Lymphedema

Objective To discuss the value of interstitial magnetic resonance(MR) lymphography in the evaluation of lymphatic dynamics.Materials and Methods An experimental model of the lymphedema of one hind leg,based on modification of Danese's method,had been obtained in 13 New Zealand White rabbits,another hind leg of each rabbit was assigned to the control limb.0.2 ml of Gadodiamide were respectively injected subcutaneously into the interdigitial skin of the dorsal aspect of each hind leg of 13 rabbits.Immediately,the injection site was gently massaged for about 30 seconds.The pre-and post-contrast enhanced three-dimensional magnetic resonance lymphography(3D MRL) were obtained,the delayed MR lymphographic images were also performed.The signal intensity of the regional lymph nodes were quantitativey assessed by the time-intensity curve.Results Intensity at peaks 10 minutes,20 minutes and 30 minutes after the injection were demonstrated in popliteal,inguinal,iliac,and paraaortal lymph nodes in the control limb respectively.The peak enhancement of distal inguinal and iliac lymph node were presented decline and delay in different stages of limb lymph edema in experimental group.Conclusion Interstitial MR lymphography is capable of quantitatively evaluating lymphatic dynamics in drainage lymphatic vessels.