Diagnosis of cystic lymphatic malformation with indocyanine green lymphography in children
10.3760/cma.j.cn114453-20200818-00474
- VernacularTitle:吲哚菁绿淋巴造影在儿童囊性淋巴管畸形诊断中的应用
- Author:
Tao HAN
1
;
Yi JI
;
Jijun ZOU
;
Haini CHEN
;
Jianbing CHEN
;
Jie CUI
;
Weimin SHEN
Author Information
1. 南京医科大学附属儿童医院烧伤整形科 210008
- Keywords:
Cystic lymphatic malformation;
Indocyanine green;
Lymphography;
Diagnosis;
Children
- From:
Chinese Journal of Plastic Surgery
2021;37(12):1333-1338
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of the indocyanine green lymphography in diagnosing cystic lymphatic malformations (cLM) in children.Methods:Between October 2019 and August 2020, patients with cLM were treated in the Department of Burns and Plastic Surgery of Children’s Hospital of Nanjing Medical University. After preoperative intracutaneous and subcutaneous injection of indocyanine green, a near-infrared fluorescence imaging system was performed to observe the lymph flow. The number, morphology, contraction frequency of afferent lymph vessels, as well as dermal backflow, were recorded.Results:Thirty-two cases of cLM were enrolled in this study. The male-to-female ratio was 18∶14, with age ranging from 3 months to 8 years. All cLMs were histologically categorized as macro-cystic (16 cases), micro-cystic (six cases), and mixed-cystic (ten cases). Only one afferent lymph vessel was detected in most of the macro-cystic cases (14/16) and mixed-cystic cases (8/10), while all micro-cystic cases (6/6) had more than two inflows. The afferent lymph vessel in macro-cystic cases and mixed-cystic cases demonstrated the normal structure. In contrast, the inflow vessels in micro-cystic LM were tortuous and small, and a dermal backflow was recorded in one case. The contraction frequency of the afferent lymphatic vessels ranged from 0.40 to 1.50 times per min, with an average of 0.80 times per min. Another two cases were confirmed not lymphangiogenic by indocyanine green lymphography and postoperative pathology.Conclusions:Indocyanine green lymphography renders a reliable, safe, and useful approach for diagnosing cLM. The application of this technique is considered effective for exploring the cLM pathogenesis, evaluation of differential diagnosis, and appropriate selection of surgical intervention.
