LYMPHSCINTIGRAPHIC EVALUATION OF MANUAL LYMPHATIC DRAINAGE FOR LOWER EXTREMITY LYMPHEDEMA

Abstract

To evaluate the effect of manuallymphatic drainage on technetium-99mlabeleddextran (99mTcDx) transport, 16patients with lymphedema of lower extremitiesunderwent two lymphscintigraphy exams byinjecting 99mTcDx intradermally into the firstinterdigital space of the affected extremity.The first was a control examination at restfollowed by an examination which included amanual lymphatic drainage session after theinjection of the 99mTcDx. Images wereobtained 45 minutes and three hours afterthe injection of the radioisotope. Extremityvolumes were also measured before and afterthe drainage session. The findings from theexaminations were assessed in a quantitative,semiquantitative and qualitative manner andcompared without and with drainage. Theanalyses of the extremities’ circumferencebefore and after the drainage by paired t-testrevealed a significant decrease. The analysesof the quantitative, semi-quantitative andqualitative evaluations evidenced no significantdifference, without or with drainage,within the 45-minute and three-hour periods.Thus, manual lymphatic drainage caused aneffective reduction in the circumference of theextremities but did not have a significanteffect in the transport of 99mTcDx.