Reliability of Clinical Signs to Diagnose Lower Limb Lymphedema in Comparison to Immediate and Delayed Near Infrared Fluoroscopic Lymphangiography | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 15, Issue 2, July 2022, Page 132-138 PDF (402.42 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asjs.2022.246370 | ||||
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| Authors | ||||
| Ahmed Sawaby1; Rafik Mohamed2; Islam Atta3 | ||||
| 1Lecturer of Vascular Surgery, Faculty of Medicine, Port Said University, Egypt | ||||
| 2Lecturer of Radiology, Faculty of Medicine, Alexandria University, Egypt | ||||
| 3Assistant Professor of Vascular surgery, Faculty of medicine, Kafr El-Shikh University, Egypt | ||||
| Abstract | ||||
| Objective: Diagnosis of lower limb lymphedema depends on clinical signs in most health organization. One of the recent investigational tools for lymphedema diagnosis is near infrared fluoroscopy lymphangiogram. The aim of our study was to evaluate the accuracy of clinical signs in lymphedema diagnosis in comparison to fluoroscopic lymphangiography. Also, to know the value of immediate and delayed lymphangiography in clinically diagnosed lymphedema patients. Patients and methods: Prospective Cohort study of 44 patients with 73 lower limbs swelling. All patients assessed by history, clinical examination. Body mass index has been measured. Immediate and delayed findings (After 24 hours) of near infrared lymphography of subcutaneous injection of Indocyanine Green has been documented. Results: The sensitivity and specificity of clinical signs in predicting fluoroscopic -confirmed lymphedema were 77% and 58% respectively. The overall accuracy was 69 %. Forty six out of 73 limb swellings showed the classical clinical signs of lymphedema. Twenty five of them showed normal lymphatic pattern by immediate fluoroscopy. One half of this group showed changes of images of fluorescent lymphangiography after 24 hours of injection into dermal backflow pattern. The sensitivity of clinical signs in predicting lymphedema was 77%, specificity was 58%. The overall accuracy was 69%. Conclusions: These results would suggest clinical signs of lymphedema unreliable in making a correct diagnosis of lymphedema in about one third of pateints. Also, we cannot rely on immediate lymphangiographic fluoroscopy to exclude lymphedema. | ||||
| Keywords | ||||
| Lymphedema; Lymphangiography; Near Infrared Fluoroscopy | ||||
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