How is a lymphoscintigraphy
of the lower limbs performed?
Why perform a lymphoscintigraphy of the lower limbs in the case of
of lipedema? How is this examination performed? And what is the purpose of the lymphatic system?
What is the lymphatic system?
The lymphatic system is a network of lymphatic vessels that connects tissues to lymphatic organs in which lymph circulates. 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.
If you have lipedema, you will probably need to have your lymphatic system examined. This examination is called a lymphoscintigraphy of the lower limbs.
Why perform a foot lymphoscintigraphy?
Lymphoscintigraphy of the lower limbs is a functional imaging test that examines the lymph vessels and nodes. It is requested as part of an assessment of edema in the lower limbs and performed prior to any surgery.
It complements the clinical examination and allows for:
- Find out whether lipedema is associated with a lymphatic disorder.
- Find out whether lipedema has already damaged the lymphatic system.
- Plan ahead for longer rehabilitation for one leg or not.
Please note that the W.A.L. liposuction technique used by Dr. Nicolas Zwillinger in lipedema surgery never damages the patient'slymphatic system.
How is the exam conducted?
The examination usually takes half a day and is performed on an outpatient basis. You do not need to fast; you can eat and take your medication as normal.
In practical terms, when you undergo a lymphoscintigraphy of the lower limbs, the doctorinjects a small amount of tracer under the skin of your feet. The product is composed of macroaggregates of human serum albumin, labeled with 99m Technetium, derived from blood products. It is not allergenic.
A first series of images is taken immediately after the injectionusing a device called a gamma camera. This first series of images takes about an hour. You will lie on an examination table under the camera and will need to remain completely still during the injection and while the images are being taken. These images show how the product is transported from the lymphatic vessels to the lymph nodes.
You willthen need towalk for an hour to stimulate lymphatic circulation. You must keep moving.
A second series of imagesis taken during the hour following this walk.
Depending on the results, a third series may be performed. You will then meet with the nuclear medicine physician, who will explain the results to you. The results will be sent to your primary care physician and, in the case of lipedema surgery, to your surgeon.
Lymphoscintigraphy of the foot is indicated as part of the preoperative assessment of lipedema. It allows for the diagnosis of possible primary lymphedema or, conversely, its exclusion.
Don't forget before your exam:
As with any exam, please bring:
- Your health insurance card and mutual insurance certificate.
- Your doctor's prescription.
- Your previous Doppler ultrasound scans, in particular.