A multiscintigraphic approach to imaging of lymphedema and other causes of the congenitally enlarged extremity.

Nuclear imaging in the definition of the components of the congenitally enlarged extremity is important in the design of a successful therapeutic regimen. In our series of 32 patients evaluated for primary lymphedema, 85% were determined to have abnormalities that were not purely lymphatic in origin. The multiscintigraphic approach defines the components of the lymphatic and vascular systems with the use of technetium-99m [99mTc] antimony sulfide colloid (99mTc Sb2S3) for lymphatic, 99mTc diethylenetriamine pentacetic acid (DTPA) for capillary-interstitial, and 99mTc-tagged red blood cells for venous systems.