Lymphogram

When Lymphografie or lymphography is a technique of radiation diagnosis for imaging of lymphatic vessels and lymph nodes. It will be applied different variants, but in principle based on the same principle:

There are applied test substances that are transported to the lymph and

• Either in the X-ray image are clearly visible ( iodinated contrast agent)
• Or are weakly radioactive and the radiation registered with appropriate detectors and can be converted to anatomical overview images ( Lymphszintigrafie ).

In X-ray Lymphografie a distinction between direct and indirect Lymphografie and Lymphszintigrafie.

Direct Lymphografie

This process is quite complex. It can be used for the lymphatic drainage of the arms and legs and the other lymphatic drainage in the torso, including the lymph nodes. It is with respect to the representation of the anatomical relationships most accurately and thus allows the assessment of relatively fine structures. After dye label of the local lymphatic vessels and operational exposure under local anesthesia is a direct injection of contrast medium ( 16-20 ml) is made ​​into the lymphatics up to two hours with a special pump. X-ray images during the injection and up to 32 hours thereafter at intervals documented anatomically quite correctly both the lymphatics and the lymph nodes in the entire abstromgebiet the retrieved lymph vessels and allow conclusions to certain diseases, such as malignant disease of the lymphatic system ( leukemia, lymphoma, metastatic carcinoma ) and lymphatic drainage to.

Indirect Lymphografie

This method is less time- consuming, but also less accurate. Here's an X-ray contrast agent is injected into or under the skin and removed with the Gewebelymphe in the local lymph channels and lymph nodes, which are visible on x-ray then. Since only very small quantities of specifically gewebsfreundlichen contrast agent can be used and the removal does not always work, this method can only be used to study the local lymphatics and lymph nodes. It is mainly used for the clarification of Lymphtransportstörungen or inflammatory diseases.

Overall, the Lymphografieverfahren other hand, have lost much in recent decades as a result of improvements in the accuracy of computed tomography and magnetic resonance imaging on the one hand and the treatment methods of importance and are only rarely used.

Lymphszintigrafie

Like all nuclear medicine procedures has also Lymphszintigrafie a relatively poor level of detail, since the spatial resolution - even the modern detectors - for the weak radioactive counts of indirect injected test substances is inherently limited. It can be essentially only checks the function of the Lymphabtransports and quantitative detection of lymph nodes to be performed. A qualitative assessment of the fine shape is not possible.

A current importance for the Lymphszintigrafie has emerged in recent years in the treatment of breast, prostate and penile cancer. On the one hand it is to have crucial for prognosis and treatment of these cancers reliable statements about the tumor spread in the local lymphatic drainage. On the other hand, the surgical exploration is expensive and quite connected with certain risks for the patients ( lymphatic drainage ). Studies have shown that it is sufficient to examine the first lymph node that is reached from Lymphabstrom of the tumor. If the sentinel lymph node (English: sentinel lymph node ) infested, the fullest possible removal ( lymphadenectomy ) of all local lymph nodes must be done. Here found no infection, it can be assumed with reasonable certainty that no scattering has taken place in the lymphatic system ..

Here the Lymphszintigrafie is a current area of ​​operation. Before the operation, small deposits of a weakly radioactive test substance are injected into the tissue around the tumor, then the removal is pursued with the lymph. Imagine one or more lymph nodes is, they can be located accurately and marked for the surgeon with a small paint mark on the patient's skin over it.

During the operation, the surgeon uses special measuring probe to visit the lymph nodes due to the stored radioactivity specifically refer to and send to Gewebsuntersuchung.

Radiation exposure

Allen Lymphografieverfahren is a radiation exposure to intrinsically by X-rays or radioactive decay ( Lymphszintigrafie ). The load depends on the number of acquired x-ray images or administered activity amount ( approximately 20-30 MBq Tc- 99m approximately one-thirtieth compared to a brain, heart or bone scintigraphy ) from.

Among the competing processes only magnetic resonance imaging is performed without ionizing radiation.