Why perform a lymphoscintigraphy of the lower limbs in the case of lipedema? How is this examination performed? And what is the purpose of the lymphatic system?
How a lymphoscintigraphy of the lower limbs is performed.
What is the lymphatic system?
The lymphatic system is a network of lymphatic vessels that connects tissues to the lymphatic organs through which lymph flows. The lymphatic organs are the bone marrow, thymus, lymph nodes, tonsils and spleen. Lymph plays an essential role in the proper functioning of the immune system. In the event of lipedema, you will certainly need to have your lymphatic network examined. This is called a lymphoscintigraphy of the lower limbs.
Why perform pedal lymphoscintigraphy?
Pedal lymphoscintigraphy (i.e. of the lower limbs) is a functional imaging test that studies lymphatic vessels and lymph nodes. It is requested as part of an assessment of edema of the lower limbs, and performed prior to any surgery. It complements the clinical examination and enables :
- Know whether or not lipedema is associated with lymphatic disease.
- Find out whether lipedema has already damaged the lymphatic system.
- Plan ahead for longer rehabilitation for one leg or not.
The W.A.L. liposuction technique used by Dr Nicolas Zwillinger for lipedema surgery never damages the patient’s lymphatic system.
How does the exam work?
The examination generally takes half a day and is performed on an outpatient basis. You don’t have to fast, and you can eat and take your medication as usual.
In practical terms, when you undergo lymphoscintigraphy of the lower limbs, the doctor injects a small quantity of tracer under the skin of the feet. The product consists of macro-aggregates of human serum albumin, labeled with 99m Technetium, derived from blood products. It is non-allergenic. An initial series of images is taken immediately after injection, using a device called a Gamma Camera. This first series of images lasts about an hour. You will lie on an examination table under the camera, and must remain very still during the injection and the taking of images. These images show how the product is transported from the lymphatic channels to the lymph nodes.
You’ll then need to walk for an hour to stimulate lymphatic circulation. You need to keep moving.
A second series of images is taken over a period of an hour following this walk. Depending on the results, a third series may be taken. You will then be seen by the nuclear physician, who will explain the results obtained. The results will be communicated to your attending physician and to the surgeon in the case of lipedema surgery.
Pedal lymphoscintigraphy is indicated for preoperative assessment of lipedema. It can be used to diagnose or rule out primary lymphedema.
Don’t forget before your exam
As with all examinations, please bring :
- Your “carte vitale” and proof of health insurance.
- Your doctor’s prescription.
Your previous ultrasound and Doppler examinations in particular.
0 Comments