MR IMAGING, PROTON MR SPECTROSCOPY, ULTRASONOGRAPHIC, HISTOLOGIC FINDINGS IN PATIENTS WITH CHRONIC LYMPHEDEMA

E Fumiere, O Leduc, S Fourcade, C Becker, C Garbar, R Demeure, F Wilputte, A Leduc, C Delcour

Abstract


Lymphedema is a progressive disease withmultiple alterations occurring in the dermis.We undertook this study using high-frequencyultrasonography (US), magnetic resonanceimaging, proton MR spectroscopy and histologyto examine structural changes occurring inthe subcutaneous tissue and precisely describethe nature of intralobular changes in chroniclymphedema. Four cutaneous and subcutaneoustissue biopsies from patients withchronic lymphedema during lymphonodaltransplantation were studied. We performedUS with a 13.5 MHz transducer, TSE T1 andTSE T2 magnetic resonance images with andwithout fat-suppression, MR Chemical ShiftImaging Spectroscopy and histologicalevaluation on these biopsies. We found thatnormal subcutaneous septa are seen as hyperechogeniclines in US and hyposignal lines inMRI and that hyperechogenic subcutis in UScan be due to interlobular and intralobularwater accumulation and/or to interlobularand intralobular fibrosis. Our study alsoconfirms the usefulness of MR spectroscopyto assess water or fat content of soft tissue.Thus, multiple imaging modalities may benecessary to precisely delineate the nature oftissue alterations in chronic lymphedema.

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