Abstract
The anatomical challenges that exist within lymphatic diagnostics have long been acknowledged. This gracile, unidirectional system of body fluid conduits has historically been interrogated by relatively cumbersome and invasive techniques, including nuclear and radiographical approaches. More recently, we have seen the advent of a reliance upon near-infrared lymphography for dynamic assessment of lymphatic anatomy and function.1,2 In the current issue of Lymphatic Research and Biology, Hara and Makoto draw our attention to the capacity of ultrasonography to noninvasively provide relevant screening assessment for lymphatic dysfunction.
The authors report on a retrospective investigation performed on 22 subjects. After dividing the interrogated limbs into predefined anatomical zones, lymphatic findings are classified according to a schema that specifies findings as normal, ectatic, contraction-related, or sclerotic. Differentiation of putative lymphatic vessels from veins is delineated.
The authors were able to readily identify lymphatic vasculature in the medial thigh and calf, with less success in the lateral calf and the dorsum of the foot. An average time requirement for a full examination of both lower limbs was less than 7 minutes. Nearly half of the enrolled subjects had parallel near-infrared lymphography, permitting favorable comparisons between the two techniques.
Clearly, the availability of a safe, noninvasive, and reliable assessment tool for screening lymphatic characterization has the potential to provide great value in the diagnostic and peri-therapeutic evaluation of our challenging patient population.