Diagnosis and treatment of lymphedema based on lymphatic function

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  • Matsubara Shinobu
    Department of Plastic and Reconstructive Surgery, Yokohama City University
  • Yabuki Yuichiro
    Department of Plastic and Reconstructive Surgery, Yokohama City University
  • Maegawa Jiro
    Department of Plastic and Reconstructive Surgery, Yokohama City University

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Other Title
  • リンパ機能に基づいた慢性リンパ浮腫の診断と治療
  • リンパ キノウ ニ モトズイタ マンセイ リンパ フシュ ノ シンダン ト チリョウ

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Abstract

Chronic lymphedema is often staged using the classification developed by the International Society of Lymphology, which is based on clinical findings. However, the accurate diagnosis and classification of lymphatic function based on imaging findings is useful for aiding treatment selection. Ultrasonography can detect edema caused by venous disorders or other causes and is useful for checking the change in the fluid volume after treatment for lymphedema. Near infrared fluorescence lymphography with indocyanine green can be used to show the routes and flow rates of active lymph vessels near to the skin surface. The overall function of the lymphatic system can be evaluated with lymphoscintigraphy. Lymphatic vessels in superficial and deep areas can be visualized by single-photon emission computed tomography- lymphoscintigraphy（SPECT-LS）. We consider the indications, efficacy, and limitations of various treatments for lymphedema based on a combination of these examinations. It is important to select the optimal（most prognostically suitable）treatment for lymphedema based on a detailed evaluation of lymphatic function.

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