Indian Journal of Nuclear Medicine

ORIGINAL ARTICLE
Year
: 2013  |  Volume : 28  |  Issue : 3  |  Page : 134--137

Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema


Ahmed Abdel-Samie Kandeel1, Jehan Ahmed Younes1, Ahmed Mohamed Zaher2 
1 Department of Nuclear Medicine, Kasr Al-Ainy Hospital (NEMROCK), Cairo, Egypt
2 Department of Nuclear Medicine, National Cancer Institute, Cairo University, Cairo, Egypt

Correspondence Address:
Ahmed Abdel-Samie Kandeel
No. 1424, 7th Neighborhood, 4th District, 6 October City, Postal Code 12573, Giza
Egypt

Purpose : To examine the frequency and significance of visualization of popliteal nodes during lymphoscintigraphy for the investigation of lower extremity swelling. Materials and Methods: Technetium-99m-labeled nanocolloid was injected subcutaneously in the first web spaces of both feet of 90 patients (24 males, 66 females; age range, 4-70 years) who had clinical evidence of lower limb lymphedema and were referred for routine lymphoscintigraphy; imaging was performed 5, and 90 minutes after injection without any vigorous exercise between the injection and imaging. Results: According to the scan findings, patients were divided into two groups; group I included 63 patients without popliteal nodes visualization on scanning, and group II included 27 patients with positive popliteal nodes uptake. None of patients with primary lymphedema (N = 22) due to agenesis or hypoplasia showed popliteal node uptake, whereas, patients with secondary lymphedema (N = 68) had either severe (N = 23) or partial (N = 45) lymphatic obstruction. A high positive association of popliteal node uptake with the severity of lymphatic obstruction was noted. Popliteal nodes were visualized in 26 of 57 patients with dermal back flow (46%), and in only 1 of 33 patients without dermal back flow (3%). There was a strong association between skin rerouting and popliteal node visualization (P < 0.01). Skin changes were detected in 24 patients (38%) with positive popliteal node uptake. Conclusion: Popliteal lymph nodes uptake during lymphoscintigraphy for clinical lymphedema of the lower limb indicates lymph rerouting through the deep system and raises a diagnosis of higher severity and longer duration of lymphatic dysfunction.


How to cite this article:
Kandeel AA, Younes JA, Zaher AM. Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema.Indian J Nucl Med 2013;28:134-137


How to cite this URL:
Kandeel AA, Younes JA, Zaher AM. Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema. Indian J Nucl Med [serial online] 2013 [cited 2019 Dec 15 ];28:134-137
Available from: http://www.ijnm.in/article.asp?issn=0972-3919;year=2013;volume=28;issue=3;spage=134;epage=137;aulast=Kandeel;type=0