Corinne Becker

Noncontrast Magnetic Resonance Lymphography

BACKGROUNDnDifferent imaging techniques have been used for the investigation of the lymphatic channels and lymph glands. Noncontrast magnetic resonance (MR) lymphography has significant advantages in comparison with other imaging modalities.nnnMETHODSnNoncontrast MR lymphography uses very heavily T2-weighted fast spin echo sequences which obtain a nearly complete signal loss in tissue background and specific display of lymphatic vessels with a long T2 relaxation time. The raw data can be processed with different algorithms such as maximum intensity projection algorithm to obtain an anatomic representation.nnnRESULTSnStandard T2-weighted MR images easily demonstrate the location of edema. It appears as subcutaneous infiltration of soft tissue with a classical honeycomb pattern. True collection around the muscular area may be demonstrated in case of severe lymphedema. Lymph nodes may be normal in size, number, and signal intensity; in other cases, lymph nodes may be smaller in size or number of lymph nodes may be restricted. MR lymphography allows a classification of lymphedema in aplasia (no collecting vessels demonstrated); hypoplasia (a small number of lymphatic vessels), and numerical hyperplasia or hyperplasia (with an increased number of lymphatic vessels of greater and abnormal diameter).nnnCONCLUSIONnNoncontrast MR lymphography is a unique noninvasive imaging modality for the diagnosis of lymphedema. It can be used for positive diagnosis, differential diagnosis, and specific evaluation of lymphedema severity. It may also be used for follow-up evaluation after treatment.

Réparation du nerf périphérique: intérêt des colles biologiques et de la suture épipérineurale dans les interventions tardives: Etude expérimentale chez le rat

In order to approximate as close as possible genuine clinical conditions, the sciatic nerve of the rat was divided and then repaired after a delay of one or seven days either by application of a biological glue or by an epiperineural suture technique. The metabolic activity of the sciatic nerve Schwann cells - whether located in the distal or the proximal ends - and that of the (fast acting) white gastrocnemius and (slow acting) red soleus muscle were assessed using 32P-radiolabeled acid-soluble phosphates. Delayed repair, as judged by our biochemical criteria, was equivalent whatever method, biological glue or suture, was used. The frozen and lyophilized forms of the biological glue provided similar results.Resume Pour se rapprocher des conditions cliniques reelles, la section haute du nerf sciatique et sa reparation differee par une suture epiperineurale classique ou par une colle biologique ont ete etudiees chez le rat. Lactivite metabolique des cellules de Schwann du nerf sciatique — segments distal et proximal — et celle des muscles gastrocnemien (muscle rapide) et soleaire (muscle lent) ont ete suivies par le radiomarquage des phosphates mineral et organiques acido-solubles. Lorsque la reparation est retardee de un ou de sept jours, la recuperation obtenue par lassemblage a la colle biologique se revele etre equivalente, au niveau des criteres retenus, a celle obtenue par la suture epiperineurale. Les formes congelee et lyophilisee de la colle biologique donnent des resultats similaires.

Increased muscle regeneration after repair of divided motor nerve with neuronotrophic factors containing glue

Neuronotrophic factors (NTFs) directed to spinal cord motor neurons were collected in rats within silicone nerve regeneration chambers according to LONGO et al. (1983b). Unilateral addition of NTFs to the fibrin glue used for the repair of divided sciatic nerves improved locally nerve regeneration without affecting the controlateral side. Nerve regeneration was assessed by weight gain of the reinnervated muscles and by radioactive labelling of the acid-soluble phosphate fractions of both nerve Schwann cells and reinnervated muscle cells. Fast gastrocnemius and slow soleus muscles, the motor nerve of which had been repaired with added NTFs, were significantly heavier (21 and 28%) than their controlateral controls, and the metabolic dedifferentiation attendant on post-division nerve repair was less marked. It is suggested that this experimental nerve regeneration model is suitable to test potential nerve-active agents in vivo, under conditions close to the usual clinical setting, with, as ultimate goal, the improvement of the end-results of microsurgical repair of peripheral nerve in man.

Nerve and Muscle Regeneration after Axonal Division in Rats Treated with Isaxonine Phosphate (Isopropylamino-2-Pyrimidine Phosphate)

Isaxonine phosphate (isopropylamino-2-pyrimidine phosphate), a neurotrophic agent, was tested on Schwann cell and muscle metabolism as evidenced by radiophosphate uptake in the inorganic phosphate and organic-bound acid-soluble phosphate fractions. It had no demonstrable effect either on sciatic nerve Schwann cells above and below an experimental crush or on the corresponding gastrocnemius and soleus muscles in their denervated and reinnervated state (7th to 28th postoperative day). It also failed to influence the end results (150th postoperative day) at nerve and muscle level after surgical division of the nerve and repair by either microsuture or fibrinogen adhesive.

Primary chylous vaginal discharge demonstrated with noncontrast magnetic resonance lymphography

Primary chylous vaginal discharge is rare. It can be associated with lower limb, pelvic, or vulvar lymphedema or cutaneous vesicles in the perineum, labia, or legs. An analysis of vaginal discharge is helpful to reveal milky fluid with chylomicrons and a triglyceride rate greater than 11xa0mL/L [1]. In the present case, chylous vaginal discharge was due to a hyperplasia–dysplasia of lymphatics in the pelvis abutting the uterus, cervix, and vagina. n nThis article is protected by copyright. All rights reserved.

Lymphographie par résonance magnétique thoracique

Lymphangio-MRI is a non-invasive technique that allows the precise imaging of thoracic lymphatic vessels without contrast-enhancing agents. This technique is still in progress, and will benefit from better knowledge of thoracic lymphatic diseases and further improvement of MRI spatial resolution.