patent blue

  • 文章类型: Journal Article
    位于胸膜下的肺结节对外科医生来说是围手术期看不见的。他们的精确识别通常可以通过触诊进行,但通常以进行开胸手术为代价。该研究的目的是评估术前使用专利蓝V和碘对比剂的混合物进行CT引导标记胸膜下局部结节的成功率和可行性,然后进行解剖外视频辅助胸腔镜手术(VATS)切除。未进行节段切除术或肺叶切除术的患者。
    连续肺结节位于距顶叶胸膜≤30mm的患者的数据,对2017年至2023年期间接受VATS解剖外切除手术的患者进行回顾性回顾和分析.所有需要进行VATS切除的患者在手术前立即在CT引导下进行肺部病变区域的彩色标记。主要结果是标记成功。形态学病变特征,从标记到手术的时间,手术相关并发症,分析了最终的组织学发现和30天的死亡率.此外,我们评估了成功标记与患者吸烟史的相关性.
    共标记了62个病灶。在56/62(90.3%)患者中观察到成功的标记。从病变标记到手术开始的中位时间为75.0(IQR65.0-85.0)分钟。6例(9.7%)患者出现手术相关气胸,1例(1.6%)患者的实质内血肿。胸膜下病变位置的深度无统计学意义的关联,观察到从标记到手术的并发症或时间以及成功标记。30天死亡率为零。没有观察到吸烟和成功标记的关联。
    用专利蓝V和碘造影剂的混合物在CT引导的控制下标记胸膜下肺部病变的方法是一种安全有效的方法,并发症最少。在计划的解剖外VATS切除之前,它为外科医生提供了受影响的肺实质的精确可视化。
    UNASSIGNED: Subpleural located pulmonary nodules are perioperatively invisible to the surgeon. Their precise identification is conventionally possible by palpation, but often at the cost of performing a thoracotomy. The aim of the study was to evaluate the success rate and feasibility of the pre-operative CT-guided marking subpleural localized nodule using a mixture of Patent Blue V and an iodine contrast agent prior to the extra-anatomical video-assisted thoracoscopic surgery (VATS) resection in patients for whom the primary anatomical resection in terms of segmentectomy or lobectomy was not indicated.
    UNASSIGNED: The data of consecutive patients with pulmonary nodules located ≤ 30 mm from the parietal pleura, who were indicated for VATS extra-anatomical resection between 2017 to 2023, were retrospectively reviewed and analyzed. All patients indicated for VATS resection underwent color marking of the area with the pulmonary lesion under CT-guided control immediately before the surgery. The primary outcome was the marking success. Morphological lesion characteristics, time from marking to the surgery, procedure related complications, final histology findings and 30day mortality were analyzed. Additionally, we assessed the association of the successful marking and the patient\'s smoking history.
    UNASSIGNED: A total of 62 lesions were marked. The successful marking was observed in 56/62 (90.3%) patients. The median time from the lesion marking to the beginning of surgery was 75.0 (IQR 65.0-85.0) minutes. The procedure related pneumothorax was observed in 6 (9.7%) patients, intraparenchymal hematoma in 1 (1.6%) patient. No statistically significant association of the depth of the subpleural lesion\'s location, occurrence of complications or time from the marking to surgery and the successful marking was observed. The 30day mortality was zero. No association of smoking and successful marking was observed.
    UNASSIGNED: The method of marking the subpleural pulmonary lesions under CT-guided control with a mixture of Patent Blue V and iodine contrast agent is a safe and effective method with minimal complications. It provides surgeons the precise visualization of the affected pulmonary parenchyma before the planned extra-anatomical VATS resection.
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  • 文章类型: Journal Article
    脂质干扰使用比色法进行的吸光度测量。为了监测血脂,一些系统使用分析仪测量吸光度。本报告描述了一种新的不伴有血脂的血脂指标干扰病例。一名64岁的巨大基底细胞癌妇女接受了切除和前哨淋巴结活检。在前哨淋巴结切除期间,患者已皮下注射专利蓝。手术后,她的血清和尿液呈黄绿色,和血脂指数,通过使用JCA-BM8040化学分析仪测量658nm(主波长)和694nm(次波长)处的吸光度来计算,很高。比较患者血清和专利蓝溶液的吸收光谱,以确定高脂血症指数的原因。患者血清和专利蓝溶液在波长540至698nm之间显示吸收。此外,专利蓝的吸光度是浓度依赖性的。因此,这些结果表明患者的血清含有专利蓝。这里,我们报告了一例专利蓝影响血脂指数的病例。因此,必须注意,在评估血脂指数时,专利蓝注射液可能会产生不准确的结果。
    Lipids interfere with absorbance measurements conducted using colorimetric methods. To monitor lipemia, some systems measure absorbance using an analyzer. This report describes a novel case of interference with the lipemia index without lipemia. A 64-year-old woman with giant basal cell carcinoma underwent resection and sentinel lymph node biopsy. The patient had been subcutaneously injected with patent blue during sentinel lymph node resection. After surgery, her serum and urine were yellow-green, and the lipemia index, calculated by measuring absorbance at 658 nm (main wavelength) and 694 nm (secondary wavelength) using a JCA-BM8040 chemistry analyzer, was high. The absorbance spectrum of the patient\'s serum and patent blue solution were compared to determine the cause of the high lipemia index. The patient\'s serum and the patent blue solution showed absorption at wavelengths between 540 and 698 nm. Moreover, the absorbance was concentration-dependent for patent blue. These results thus indicated that the patient\'s serum contained patent blue. Here, we report a case wherein patent blue affected the lipemia index. Thus, it must be noted that patent blue injection may yield inaccurate results when evaluating lipemia index.
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  • 文章类型: Journal Article
    背景:围手术期过敏反应是罕见的,但与显著的发病率相关。GERAP在法国已经很好地描述了这种并发症(Grouped'EtudedesRéactionsAnphriculatisesPériopératoires),一个专注于研究的网络。围手术期过敏反应的流行病学正在发展,受环境因素和临床实践的影响。这项研究的目的是更新法国围手术期过敏反应的流行病学。
    方法:这项多中心回顾性研究于2017-8年在GERAP网络的26个过敏诊所进行。
    结果:纳入围手术期过敏反应患者765例。大多数病例很严重,根据Ring和Messmer分类,428(56%)反应分为3或4。有676名患者的皮肤测试结果,在471例(70%)中发现了罪魁祸首。神经肌肉阻断剂是围手术期过敏反应的主要原因(n=281;60%),其次是抗生素(n=118;25%)和专利蓝染料(n=11;2%)。头孢唑啉是引起围手术期过敏反应的主要抗生素(52%的抗生素相关反应)。甲胺铵和罗库溴铵是导致围手术期过敏反应的主要神经肌肉阻断剂,每100,000个小瓶中有7.1(6.1-8.4)和5.6(4.2-7.4)反应,分别,而头孢唑林相关病例估计为每100,000个小瓶中有0.7(0.5-0.9)个反应。
    结论:我们的结果证实,最常见的触发剂仍然是神经肌肉阻断剂。对抗生素的反应,尤其是头孢唑啉,变得越来越频繁。头孢唑啉致敏的起源未知,由于没有描述交叉敏化,这应该是进一步研究的主题。围手术期过敏反应应跟踪多年,并根据触发因素的变化进行理解。
    背景:ClinicalTrials.gov(NCT04654923)。
    BACKGROUND: Perioperative anaphylaxis is rare but is associated with significant morbidity. This complication has been well described in France by the GERAP (Groupe d\'Etude des Réactions Anaphylactiques Périopératoires), a network focused on its study. The epidemiology of perioperative anaphylaxis is evolving, influenced by environmental factors and clinical practice. The aim of this study was to update the epidemiology of perioperative anaphylaxis in France.
    METHODS: This multicentre retrospective study was performed in 26 allergy clinics of the GERAP network in 2017-8.
    RESULTS: There were 765 patients with perioperative anaphylaxis included. Most cases were severe, with 428 (56%) reactions graded as 3 or 4 according to the Ring and Messmer classification. Skin test results were available for 676 patients, with a culprit agent identified in 471 cases (70%). Neuromuscular blocking agents were the main cause of perioperative anaphylaxis (n=281; 60%), followed by antibiotics (n=118; 25%) and patent blue dye (n=11; 2%). Cefazolin was the main antibiotic responsible for perioperative anaphylaxis (52% of antibiotic-related reactions). Suxamethonium and rocuronium were the main neuromuscular blocking agents responsible for perioperative anaphylaxis with 7.1 (6.1-8.4) and 5.6 (4.2-7.4) reactions per 100,000 vials sold, respectively, whereas cefazolin-related cases were estimated at 0.7 (0.5-0.9) reactions per 100,000 vials sold.
    CONCLUSIONS: Our results confirm that most commonly identified triggering agents remain neuromuscular blocking agents. Reactions to antibiotics, particularly cefazolin, are becoming increasingly frequent. The origin of sensitisation to cefazolin is unknown, as no cross-sensitisation has been described, and it should be the subject of further study. Perioperative anaphylaxis should be followed over the years and understood given the changing triggers.
    BACKGROUND: ClinicalTrials.gov (NCT04654923).
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  • 文章类型: Journal Article
    目的:在甲状腺癌患者的随访中,经常检测到复发,在再次手术环境中定位和去除这些病变带来的挑战。这项研究旨在评估术前超声(US)引导下将专利蓝(PB)染料注入复发的有效性,以帮助其安全有效地去除。
    方法:在本回顾性分析中,我们回顾了2019年2月至2023年3月在一家三级医疗中心接受美国指导的患者的记录,这些患者在颈部再次手术前在内分泌科门诊接受了美国指导的PB注射.记录注射PB和手术开始之间的持续时间。使用超声检查评估手术的并发症和有效性,实验室,外科,和病理记录。
    结果:我们连续23例患者,28个病灶。复发平均大小为8.8mm(4.1-15.6),在所有情况下都成功染色。PB注射到切口之间的中位时间为90(35-210)分钟。无与染料注射相关的并发症。在所有情况下都可以方便地识别和去除蓝色复发。
    结论:术前超声引导下注射PB是安全的,用于定位复发性肿瘤的现成且高效的技术,即使在伤痕累累的再次手术颈部手术中的小病变。
    OBJECTIVE: In the follow-up of patients with thyroid cancer, recurrences are often detected, posing challenges in locating and removing these lesions in a reoperative setting. This study aimed to assess the effectiveness of preoperative ultrasound (US)-guided injection of patent blue (PB) dye into the recurrences to aid in their safe and efficient removal.
    METHODS: In this retrospective analysis, we reviewed the records of the patients in a tertiary care centre between February 2019 and March 2023 who underwent US-guided PB injection in the endocrinology outpatient clinic before reoperative neck surgery. The duration between the injection of PB and the initiation of surgery was recorded. The complications and effectiveness of the procedure were evaluated using ultrasonographic, laboratory, surgical, and pathologic records.
    RESULTS: We reached 23 consecutive patients with 28 lesions. The recurrences averaged 8.8 mm (4.1-15.6) in size and were successfully stained in all cases. The median time between the PB injection and the incision was 90 (35-210) min. There were no complications related to the dye injection. The blue recurrences were conveniently identified and removed in all cases.
    CONCLUSIONS: A preoperative US-guided injection of PB is a safe, readily available and highly effective technique for localising recurrent tumours, even in small lesions within scarred reoperative neck surgeries.
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  • 文章类型: Journal Article
    Superficial lymphadenectomy is an easy-to-perform and cost-effective routine technique. Despite its simplicity, it remains underutilized in veterinary medicine, with most practitioners being oncological surgeons. This study aims to enhance accessibility to the surgical procedure by providing anatomical representations of superficial lymphadenectomy in the carcasses of dogs and cats. A preliminary study involving two canines and two felines was conducted, with each group comprising a dog and a cat. Group A was designated to superficial lymphadenectomy techniques to create an illustrated step-by-step procedure, while group B underwent anatomical dissection to expose lymph nodes and their adnexa. The approach to superficial lymph nodes in dogs and cats is simple, allowing for the demonstration of superficial lymphadenectomy techniques in the corpses of dogs and cats without complications. This includes the dissection and presentation of anatomical structures adjacent to the lymph nodes. In conclusion, the techniques applied to subjects in groups A and B proved effective, successfully demonstrating and excising all superficial lymph nodes in the corpses of dogs and cats. These findings suggest that the developed set of techniques developed for lymph node excision holds promise for safe and effective application in live animals.
    A linfadenectomia superficial é uma técnica de rotina de fácil execução e custo-benefício. Apesar da sua simplicidade, continua subutilizado na medicina veterinária, sendo a maioria dos profissionais cirurgiões oncológicos. Este estudo visa melhorar a acessibilidade ao procedimento cirúrgico, fornecendo representações anatômicas de linfadenectomia superficial em carcaças de cães e gatos. Foi realizado um estudo preliminar envolvendo dois cães e dois gatos, sendo cada grupo composto por um exemplar de cada espécie. O grupo A foi designado para técnicas de linfadenectomia superficial para criar um procedimento passo a passo ilustrado, enquanto o grupo B foi submetido à dissecção anatômica para expor os linfonodos e seus anexos. A abordagem dos linfonodos superficiais em cães e gatos é simples, permitindo a demonstração de técnicas de linfadenectomia superficial em cadáveres de cães e gatos sem complicações. Isto inclui a dissecção e apresentação de estruturas anatômicas adjacentes aos gânglios linfáticos. Concluindo, as técnicas aplicadas aos indivíduos dos grupos A e B mostraram-se eficazes, demonstrando e extirpando com sucesso todos os linfonodos superficiais nos cadáveres de cães e gatos. Essas descobertas sugerem que o conjunto desenvolvido de técnicas para excisão de linfonodos é promissor para aplicação segura e eficaz em animais vivos.
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  • 文章类型: Journal Article
    狗腋窝淋巴结(ALN)在手术切除前通常很难定位。ALN的解剖位置通常会阻止兽医进行手术淋巴结清扫术。考虑到现有文献有限,转移的实际发生率和预后相关性尚不清楚.
    非随机化,对女性犬(n=41)进行了前瞻性临床研究,该犬在胸或颅腹部乳腺中患有乳腺肿瘤(MGT)。该研究根据肿瘤的临床表现调查了ALN转移的风险,肿瘤大小,组织病理学诊断和分级。这项研究的主要目的是比较有或没有专利蓝2.5%(PB)染料注射的ALN切除前哨淋巴结可视化。总共进行了46例乳腺切除术,五只动物进行了两次乳腺切除术。在第一组中,17例患者在未注射PB的情况下接受了乳房切除术和淋巴结清扫术(G1)。相比之下,在第二组中,24名患者还接受PB注射用于前哨淋巴结定位(G2)。在38/46例(82%)中发现了ALN。仅在G1(19/46)的58%的手术中鉴定并切除了ALN,而在第2组中,在92%的病例中发现了淋巴结,在100%的病例中切除了淋巴结。使用PB改善了MGT犬ALN的识别并减少了手术切除时间。
    两组的手术时间不同,因为与第1组相比,PB注射组明显缩短(80vs.45分钟)(p<0.0001)。ALN转移的总体频率为32%。淋巴结宏观异常,肿瘤大小(>3厘米),诊断为间变性癌或II/III级乳腺肿瘤与较高的ALN转移概率相关。ALN中的转移更常见,在患有大于3厘米的肿瘤并被诊断为侵袭性组织学亚型的狗中。应删除ALN以进行正确的分期,预后评估,并决定辅助治疗。
    UNASSIGNED: Dogs\' axillary lymph node (ALN) is often difficult to locate before surgical resection. The anatomical location of ALN often discourages Veterinarians from surgical lymphadenectomy. Considering the limited literature available, the actual incidence of metastases and the prognostic relevance are poorly understood.
    UNASSIGNED: A non-randomized, prospective clinical study was conducted with female dogs (n = 41) with mammary gland tumor (MGT) in the thoracic or cranial abdominal mammary glands. The study investigated the risks of ALN metastasis based on tumors clinical findings, tumor size, histopathological diagnosis and grade. The main aim of this study was to compare ALN resection with or without patent blue 2.5% (PB) dye injection for sentinel lymph node visualization. A total of 46 mastectomies were performed and five animals underwent two mastectomies. In the first group, 17 patients underwent a mastectomy and lymphadenectomy without PB injection (G1). In contrast, in the second group, 24 patients also received PB injections for sentinel lymph node mapping (G2). The ALN was identified in 38/46 cases (82%). The ALN was identified and excised in only 58% of surgeries in G1(19/46), while in group 2, the lymph node was identified in 92% of the cases and resected in 100% of the cases. The use of PB improves ALN\'s identification and reduces the surgical resection time in dogs with MGT.
    UNASSIGNED: Surgical time differed between the two groups, as it was significantly shorter in the PB injection group compared to group 1 (80 vs. 45 min) (p < 0.0001). The overall frequency of ALN metastasis was 32%. Macroscopic abnormalities in the lymph nodes, tumor size (>3 cm), and diagnosis of anaplastic carcinoma or grade II/III mammary gland tumors were associated with a higher probability of ALN metastasis. Metastases in the ALNs are more common, in dogs presenting with tumors larger than 3 cm and diagnosed with aggressive histological subtypes. The ALNs should be removed for correct staging, prognostic evaluation, and decision for adjuvant therapy.
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  • 文章类型: Journal Article
    背景:椎间盘造影是全内窥镜椎间盘切除术(FED)的组成部分,包括由造影剂和椎间盘内染色产生的具有射线不透性的普通椎间盘造影,用于可视化内窥镜视野中的环形缺损。然而,仍然担心使用的染色剂的细胞毒性。还缺乏对它们的染色功效的研究。
    目的:为了评价亚甲蓝的可行性,专利蓝,和靛蓝Carmine用于椎间盘内注射,调查每种染料的有效性,并定义临界浓度,具有足够的染色功效和可耐受的细胞毒性,可用于FED期间的色盘照相术。
    方法:体外实验研究。
    方法:由粉末制备染料储备溶液。原液用培养基或平衡盐水稀释,用于细胞毒性或椎间盘染色测定。分别。从当地的屠宰场获得牛尾巴,并通过椎间盘水平的横向切口获得椎间盘的功能性脊柱单元。使用手术刀在后外侧上穿刺每个椎间盘以模拟环形缺损。使用22G针从穿刺部位的对侧进行不同浓度的每种染料的盘内注射。使用ImageJ软件定量染色功效。在不同浓度的每种染料中培养牛尾的原代细胞。使用CCK-8毒性测定在染色暴露后24小时评估细胞毒性。
    结果:染色效力和细胞毒性与测试染料的浓度成比例。产生显著染色效果的浓度下限靛蓝,亚甲蓝,和专利蓝为0.25毫克/毫升,0.25mg/mL,和0.05mg/mL,分别。与对照组相比,对靛蓝有显著毒性的浓度,亚甲蓝,患者蓝色为1毫克/毫升,0.5mg/mL,和2.5mg/mL,分别。
    结论:由于在0.05-2.5mg/mL范围内的最大权衡浓度范围,与靛蓝或亚甲蓝相比,专利蓝可以用作更合适的组织染色剂。
    结论:专利蓝具有良好的染色效果和较低的细胞毒性的特征,可能是FED中显色的一种有希望的选择。
    Chromodiscography is an integral part of full-endoscopic discectomy (FED), comprising ordinary discography with radiopacity produced by contrast medium and intradiscal stain for visualizing annular defects in the endoscopic field. Nevertheless, concerns remain about the cytotoxicity of the stains used. The study of their staining efficacy is also lacking.
    To evaluate the feasibility of methylene blue, patent blue, and indigo carmine for intradiscal injection, investigate the effectiveness of each dye, and define critical concentration with adequate staining efficacy and tolerable cytotoxicity for use in chromodiscography during FED.
    An experimental in vitro study.
    Dye stock solutions were prepared from powder. The stock was diluted with culture medium or balanced saline and used for cytotoxicity or intervertebral disc staining assays, respectively. Bovine tails were obtained from the local slaughterhouse and functional spine units of intervertebral discs were acquired by transverse incision at the disc level. Each disc was punctured over the posterolateral aspect using a surgical knife to simulate an annular defect. The intradiscal injection was performed with each dye at different concentrations using a 22G needle from the contralateral aspect of the punctured site. Staining efficacy was quantified using ImageJ software. Primary cells of bovine tails were cultivated in each dye at different concentrations. Cytotoxicity was assessed 24 hours after stain exposure using the CCK-8 toxicity assay.
    Staining efficacy and cytotoxicity were proportional to the concentration of tested dyes. Lower limits of concentration producing significant staining efficacy of indigo carmine, methylene blue, and patent blue were 0.25 mg/mL, 0.25 mg/mL, and 0.05 mg/mL, respectively. Compared with controls, concentrations showing significant toxicity for indigo carmine, methylene blue, and patient blue were 1 mg/mL, 0.5 mg/mL, and 2.5 mg/mL, respectively.
    Patent blue can serve as a more suitable tissue stain than either indigo carmine or methylene blue due to the widest range of tradeoff concentration within 0.05 to 2.5 mg/mL.
    Patent blue with the characteristic of good staining efficacy and lower cytotoxicity may be a promising option for chromodiscography during FED.
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  • 文章类型: Journal Article
    除了治疗剂,药物含有赋形剂,如稳定剂,防腐剂,增溶剂,或者染料,其中一些与食品中的添加剂相同。对这些赋形剂的过敏反应可能是一个被低估的问题。在30多年前出现了对药物赋形剂的过敏反应的首次描述之后,多年来,相应的报告数量大幅增加。然而,当索引产品未知和/或不可用于测试时,在澄清药物过敏反应方面存在诊断差距。在目前的工作中,单独的赋形剂作为例子,关于过敏反应的出版物是可用的。此外,讨论了体内和体外过敏测试的选择。这种反应的发病机制在许多情况下仍未解决,结论中简要介绍了当前的概念。随着对药物赋形剂过敏反应的了解不断增加,假设这些可以更频繁地识别并在诊断上得到澄清。
    In addition to the therapeutic agent, drugs contain excipients such as stabilizers, preservatives, solubilizers, or dyes, some of which are identical to additives in foods. Anaphylaxis to these excipients is probably an underestimated problem. After the first descriptions of anaphylactic reactions to drug excipients appeared more than 30 years ago, the number of corresponding reports has increased significantly over the years. However, a diagnostic gap exists in the clarification of drug allergic reactions when the index product is not known and/or is not available for testing. In the present work, individual excipients are presented as examples for which publications on anaphylaxis are available. Furthermore, the options of allergological testing both in vivo and in vitro are discussed. The pathogenesis of such reactions is still unresolved in many cases, and current concepts are briefly presented in the conclusion. With increasing knowledge about anaphylaxis to drug excipients, it is assumed that these can then be recognized more often and diagnostically clarified.
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  • 文章类型: Case Reports
    BACKGROUND: Intoxication with Patent Blue V [sodium compound of (diethylamino-4-phenyl)(hydroxy-5-disulfo-2,4-phenyl) methanol] can lead to high levels of methemoglobin and metabolic acidosis. In severe cases and if not rapidly eliminated from the plasma, this can lead to multiple organ failure and death.
    METHODS: A 27-year-old Asian woman (original from Vietnam) was admitted after ecstasy intoxication resulting in multi-organ failure (acute respiratory distress syndrome, metabolic acidosis, capillary leakage syndrome, renal failure, shock refractory to standard resuscitation). As a consequence, continuous renal replacement therapy and veno-venous extracorporeal membrane oxygenation were started. Methylene blue administration to reverse vasoplegia was decided, but unfortunately, Patent Blue V was erroneously administered, resulting in a severe clinical picture of methemoglobinemia and tissue hypoxia. As a therapeutic intervention, CytoSorb hemoadsorption was initiated, and rapid and significant reduction in plasma methemoglobin, accompanied by improved hemodynamics and normalization in plasma lactate levels, was observed.
    CONCLUSIONS: This is the first case describing the application of CytoSorb hemoadsorption in a patient with ecstasy intoxication complicated by iatrogenic administration of Patent Blue V. There is a potential role for CytoSorb in drug intoxication, which needs to be confirmed in larger series.
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  • 文章类型: Journal Article
    BACKGROUND: Precise mapping of functional lymphatic vessels is essential for successful lymphaticovenular anastomosis (LVA). This study aimed to clarify the precision of magnetic resonance lymphography (MRL) in detecting lymphatic vessels prior to LVA.
    METHODS: Eighteen patients with leg lymphedema were recruited for this prospective study. All patients underwent MRL before LVA to obtain three-dimensional coordinates of lymphatic vessels from MRL images. The precision of MRL for detecting lymphatic vessels was evaluated and compared with those of other contrast techniques.
    RESULTS: Twenty legs from 18 patients were analyzed. A total of 40 skin incisions were made, 32 of which were determined by MRL. The precision of MRL to detect lymphatic vessels was 94%. With the addition of MRL, the number of lymphatic vessels identified preoperatively was increased as compared with indocyanine green lymphography (ICG-L) alone. Assuming a detection sensitivity of MRL for lymphatic vessels of 1, those of other contrast techniques were 0.90 for ICG-L under microscopy, 0.73 for patent blue staining, and 0.43 for ICG-L before incision. Whereas ICG-L before incision could not detect lymphatic vessels at depths greater than 17.0 mm, all deeper anastomosed lymphatic vessels were identified by MRL.
    CONCLUSIONS: Lymphatic vessels enhanced on MRL can be reliably identified intraoperatively. MRL is a promising preoperative examination in LVA that can selectively depict suitable lymphatic vessels even in deep tissue layers.
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