【摘要】 目的　探讨99Tcm 右旋糖酐 (DX)淋巴显像对乳糜症、淋巴管炎、肢体淋巴性水肿及淋巴瘤等疾病的诊断价值。方法　根据病种及病变部位合理选择99Tcm DX注射部位。根据病种及临床要求 ,选用动态显像、全身显像或局部平面显像。结果　①99Tcm DX显像对 2 4例乳糜症患者诊断特异性为 80 % ,灵敏度为 89 1%。②对 41例淋巴管炎诊断特异性为 83 3% ,灵敏度为 88 5 % ,淋巴管呈放射性管状浓聚。③对 116例四肢淋巴性水肿的诊断特异性为 85 7% ,灵敏度为 91 5 % ,其影像呈以下几种类型 :水肿肢体呈弥漫性放射性浓集 ;水肿肢体淋巴管及淋巴结放射性浓集 ;水肿肢体淋巴管不显影 ;水肿肢体见淋巴侧支形成。④淋巴瘤有以下几种异常图形表现 :淋巴结融合、淋巴链断裂、淋巴结肿大、淋巴交通支形成。结论　99Tcm DX淋巴显像对淋巴系统疾病的诊断具有方法简便 ,图像清晰 ,灵敏度、特异性高等优点 ,临床诊断价值高。更多还原

【Abstract】 Objective The diagnostic value of 99Tcm- dextran (DX) in chyluria, lymphangitis, lymphedema of extremities and lymphoma was evaluated. The methods of imaging and its characteristics were discussed. Methods ① Selection of injecting sites. Depending on the diseases and pathological findings to select correspondent injecting sites. ② Methods of lymphoscintigraphy. According to the diseases to select dynamic imaging, whole body imaging or planar imaging. Results ① The specificity in 24 cases of chyluria was 80%. The sensitivity reached 89.1%.② In 41 cases of lymphangitis, the specificity was 83.3%, sensitivity was 88.5%. The images were characterized as the tubular accumulation of radioactivity along the inflammatory lymph vessels.③ In 116 cases of lymphedema of extremities, the specificity was 85.7%, sensitivity was 91.5%.The findings were as follows: diffuse accumulation of radioactivity, accumulation of radioactivity in lymphatic vessels and lymph nodes in the edematous extremity, or no accumulation was noticed. In the edematous extremity, collateral vessels were demonstrated.④ The following images were seen in lymphoma: fusion of lymph nodes, disruption of lymphatic chain, enlargement of lymph nodes, formation of lymph communication; no image of the liver was seen. Conclusions In diseases of the lymphatic system, 99Tcm-DX lymphatic imaging is of diagnostic value and easy to perform. The imaging gives clear images, with relatively high sensitivity and specificity for diagnosis. It is especially of high value in the diagnosis of chyluria, lymphangitis, lymphedema of extremities and lymphoma. 99Tcm-DX lymphatic imaging, by the flowing of the tracer in the lymph, can show the lymphatic vessels, the numbers of lymph nodes, the size of diffusion of radioactivity and also abnormalities of lymphatic system, e.g., collateral lymphatic, lymphatic fistula and lymphatic regurgitation and is of high diagnostic value in diseases of the lymphatic system. It is also useful in the evaluation of changes after treatment of the relevant conditions.更多还原