OPPORTUNITIES OF USI IN DIAGNOSIS OF CENTRAL AND PERIPHERAL LYMPHATIC SYSTEM PATHOLOGY

Aim. To improve the results of treatment of patients with chronic lymphovenous failure of the lower extremities by introducing new methods for diagnosis of peripheral and central lymphodynamics. Materials and methods. Peripheral and central lymphodynamics (thoracic lymphatic channel – TLC) was studied in 40 patients with chronic lymphovenous failure (CLVF) of the lower extremities of different severity. The other 40 patients without vascular pathology signs underwent the same investigations. Lymphodynamics was studied with USI-scanner (Aloka SSD – 4000; Acuson X-300). Results. In CLVF patients, TLC orifice diameter was up to 3,24±1,32 mm. TLC arch diameter was 6,19±1,48 mm that is significantly larger than in comparison group ( p <0,01). Linear lymph flow velocity (LLFV) in the main group was 11,47±4,31 cm/s, PLFV – 117,93±69,54 ml/min. Both indices are reliably ( p <0,01) higher than in comparison group that confirms dynamic failure of TLC orifice in CLVF patients. Some peripheral lymphodynamics indices were studied. The obtained data show lymph hyperproduction, prove presence of lymphatic hypertension in patients with CLVF both at the periphery and at the TLC level as well as development of dynamic TLC orifice failure. Conclusion. The results of the study demonstrate efficiency of USI with colour duplex scanning of lymph nodes in CLVF patients for detecting lymphatic hypertension at different levels and what is especially important – at the neck TLC level.

Ultrasound investigation, thoracic lymphatic channel (TLC), TLC orifice, chronic lymphovenous failure, lymphodynamics