MR Features in Lymphedema and Phlebedema of Extremities

ABSTRACT

PURPOSE: Authors analyzed the MR findings of swollen extremities to evaluate the MR features of lymphedema and phlebedema. MATERIALS AND METHODS: We reviewed MR imagings of 17 cases of swollen extremities, including 12 lymphedemas and 5 phlebedemas. We obtained axial TI-, T2-, and Gd-DTPA enhanced T1WIs using 1.0T superconducting magnet and measured cross-sectional areas of subcutaneous and subfascial tissues of a slice with grossly largest cross-sectional area using perimeter. We also analyzed changes in the signal intensities of the subcutaneous and subfascial tissues on T2WI, presence of enhancement on Gd-DTPA enhanced T1WI, and presence of skin thickening. RESULTS: Both subcutaneous and subfascial tissues of swollen extremities were increased in the cross-sectional areas than those of contralateral normal side. The subcutaneous compartment in lymphedema was statistically significantly increased in cross-sectional area than subfascial compartment in lymphedema(p<0.005) and subcutaneous tissue in phlebedema(p<0.05). Increased signal intensities and characteristic "honeycomb appearance" of subcutaneous tissue in the lymphedema were specific findings on T2WI. CONCLUSION: MR imaging was useful and noninvasive method in the diagnosis of swollen extremities. There were increased cross-sectional area of subcutaneous compartment with "honeycomb appearance" in lymphedema and increased signal intensities of both subcutaneous and subfascial compartment in phlebedema on the T2WI.