Functional Study of the Limb Lymphatic System

Abstract

Radionuclide lymphoscintigraphy with rhenium sulphide colloid (RSC), average particle size 40 nm was used as a functional test of the limb lymphatic system. When injected subcutaneously in the hand or the foot all the RSC which leave the injection site enters the lymphatic system. From the disappearance time-activity curve detected over the injection site, we calculated the half-life and the lymphatic colloidal clearance (LC) of the RSC. These two parameters appeared to be closely depending on the macrophage function and on the permeability of the initial lymphatics. We also measured the necessary time for RSC to reach the knee or the elbow and calculated a lymphatic speed (LS) closely related to the lymph flow. The study was first carried out on 40 healthy volunteers and then on 221 patients with limb lymphoedemas. The reproducibility of the method was good when 4 days at least separate two functional tests ( r = 0.95 for half-life, r = 0.86 for lymphatic clearance at the injection site and r = 0.93 for lymphatic speed). In addition with the lymphatic images detected 1 h after the injection the functional study may become a useful technique to differentiate the lymphatic drainage diseases.