Friday, February 24, 2012

Lymphedema of the lower limbs: CT staging

Another older article from 2002, that discusses CT staging of leg (lower limb) lymphedema.

Doctors have long maintained that these radiography scans can be valuable in assesing the stages of lymphedema and in understand the physiology of a lymphedematous leg. However, this remain tremendously difficult for several reasons.

First, not many doctors appear to be well trained to interpret these scans in as much as lymphedema is concerned.

Secondly, even if a doctor was able to interpret a CT scan, there really is no specific diagnostic criteria for such a diagnoses or staging.

Notice too, in the study, the comments regarding the difference between the description of a primary lymphedema thigh versus a secondary one.

The abstract follows:

Lymphedema of the lower limbs: CT staging].

[Article in French]


Hôpital Saint-Michel, 33, rue Olivier-de-Serres, 75015 Paris, France.


Routinely performed, CT is useful and reliable for staging lower limb lymphedema. We describe methods we utilized. We found in frequency order: skin thickening, subcutaneous tissues area increase in regard the safe limb, perimuscular aponevrosis thickening, fat infiltration: lines parallel to the skin, edematous areas along perimuscular aponevrosis, lines perpendicular to the skin. The lowest fat density is increased on the pathologic side. Subfascial compartment is slightly fattened. We found huge differences between primary and secondary lymphedema for the thigh. Same images may be generated by old or young lymphedema. Rarely useful for positive diagnosis, CT is indispensable for secondarylymphedema staging (initial staging or after a recent increase). It seems us indispensable for any pretherapeutic staging (whole objectively disorders, exact upper limit, infraclinic bilaterality).


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