Improvement of Lymphatic Function after Complex Physical Therapy Change of Lymphoscintigraphy

ABSTRACT

OBJECTIVE: Lymphoscintigraphy is the diagnostic test of choice in patients with suspected lymphedema. This reveals functional information rather than anatomic details. We evaluated the improvement of lymphatic function after complex physical therapy(CPT) in patients with lymphedema via lymphoscintigraphic follow-up examination. METHOD: In 19 lymphedema patients(22 extremities) regardless of etiology, lymphoscintigraphy using Tc-99m antimony sulfide colloid was performed before and 3-month after CPT. Main lymphoscintigraphic findings of lymphedema and lymphoscintigraphic changes after CPT were evaluated. RESULTS: Main lymphoscintigraphic findings of lymphedema were the presence of dermal backflow(100%) and collateral vessels(68.2%), non-visualized or barely visualized lymph nodes (95.5%), and non-visualized or barely visualized lymphatic vessels(27.3%). The findings of lymphoscintigraphy suggesting improvement of lymphatic function after CPT were decreased dermal backflow(72.7%), increased radioisotope uptake of lymph nodes(9.1%) and increased radioisotope uptake of lymphatic vessels(27.3%). Increased dermal backflow itself with decreased total tissue pressure after CPT was not the finding implying deterioration of lymphatic function. There was no constant correlation between clinical improvement and lymphoscintigraphic improvement. CONCLUSION: The lymphoscintigraphic follow-up examination combined with volumetry is useful in assessing the improvement of lymphatic function in lymphedema.