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Lymphatic imaging diagnosis based on lymphatic anatomy

Research Project

Project/Area Number 19H03814
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 56070:Plastic and reconstructive surgery-related
Research InstitutionOkayama University

Principal Investigator

Kimata Yoshihiro  岡山大学, 医歯薬学域, 教授 (50392345)

Co-Investigator(Kenkyū-buntansha) 品岡 玲  岡山大学, 医歯薬学域, 教授 (90724500)
小野 敦  川崎医療福祉大学, 医療技術学部, 教授 (20804743)
中嶋 真大  岡山大学, 大学病院, 主任診療放射線技師 (20886329)
山田 潔  岡山大学, 医歯薬学総合研究科, 准教授 (10319965)
Project Period (FY) 2019-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥17,160,000 (Direct Cost: ¥13,200,000、Indirect Cost: ¥3,960,000)
Fiscal Year 2021: ¥10,010,000 (Direct Cost: ¥7,700,000、Indirect Cost: ¥2,310,000)
Fiscal Year 2020: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2019: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Keywordsリンパ管 / リンパ浮腫 / 解剖 / リンパ管造影 / ICG蛍光リンパ管造影 / リンパシンチグラフィ / リンパ管静脈吻合術 / リンパ系解剖 / 手術治療 / 評価方法の確立
Outline of Research at the Start

1年目は、下腿リンパ管・鼠径リンパ節・骨盤リンパ節の更なる詳細な解剖学的研究を実施
2-3年目に、1年目の詳細な解剖学的情報を用いて、すでに確立してきたICGリンパ管造影法に加えて、ALBリンパシンチグラフィーの手技とリンパ浮腫に対する評価方法を確立する。具体的には、健常者とリンパ浮腫患者を対象とした評価方法の確立のための介入研究となる。
これらの診断の標準化は、超早期リンパ浮腫の診断や、術後の評価のための非常に重要なステップとなり、これはリンパ管-静脈吻合術やリンパ節移植術など手術手技に、浮腫の病態に応じた根拠を与えることに結び付く。

Outline of Final Research Achievements

The anatomy of the lower extremity lymphatic vessel is clarified using ICG fluorescent lymphangiography and CT lymphangiography. It reveals that the lower extremity has at least four cutaneous territories, four groups of lymphatic vessels, each corresponding to three lymph nodes. Comparison of lymphoscintigraphy and ICG fluorescent lymphangiography in the same patients showed that the sensitivity of scintigraphy is markedly lower than that of ICG, especially in early-stage cases, where only about half of the cases can be detected. It has also been found that certain groups of lymphatic vessels are more likely to be affected in the early stages of the disease, and that as the disease progresses, defects in lymphatic vessel groups occur.

Academic Significance and Societal Importance of the Research Achievements

本研究により、下肢リンパ系の解剖が皮膚からリンパ節まで明らかになった。その情報はICGやシンチなどの画像検査の手技読影方法を改善させた。その改善された検査手技を持っても、特に早期の症例では、ICG蛍光リンパ管造影検査の方が感度の点で優れていることが明らかになっている。
これらの情報は適切な画像診断法を提供し、早期発見に貢献する。

Report

(4 results)
  • 2022 Final Research Report ( PDF )
  • 2021 Annual Research Report
  • 2020 Annual Research Report
  • 2019 Annual Research Report
  • Research Products

    (8 results)

All 2022 2021 2020 2019

All Journal Article (6 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 6 results,  Open Access: 2 results) Presentation (2 results) (of which Invited: 2 results)

  • [Journal Article] A new severity classification of lower limb secondary lymphedema based on lymphatic pathway defects in an indocyanine green fluorescent lymphography study2022

    • Author(s)
      Shinaoka Akira、Kamiyama Kazuyo、Yamada Kiyoshi、Kimata Yoshihiro
    • Journal Title

      Scientific Reports

      Volume: 12 Issue: 1 Pages: 153-158

    • DOI

      10.1038/s41598-021-03637-6

    • NAID

      120007190702

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] A phase III, multicenter, single-arm study to assess the utility of indocyanine green fluorescent lymphography in the treatment of secondary lymphedema.2022

    • Author(s)
      Akita S, Unno N, Maegawa J, Kimata Y, Fukamizu H, Yabuki Y, Kitayama S, Shinaoka A, Yamada K, Sano M, Ota Y, Ohnishi F, Sakuma H, Nuri T, Ozawa Y, Shiko Y, Kawasaki Y, Hanawa M, Fujii Y, Imanishi E, Fujiwara T, Hanaoka H, Mitsukawa N.
    • Journal Title

      Vasc Surg Venous Lymphat Disord

      Volume: 10 Issue: 3 Pages: 728-737

    • DOI

      10.1016/j.jvsv.2021.09.006

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] The use of 33 MHz ultra-high-frequency ultrasonography for the evaluation of sweat glands in the axilla with osmidrosis2021

    • Author(s)
      Shinaoka Akira、Nakahara Ryuichi、Saeki Masanori
    • Journal Title

      PLOS ONE

      Volume: 16 Issue: 5 Pages: e0251600-e0251600

    • DOI

      10.1371/journal.pone.0251600

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Lower-Limb Lymphatic Drainage Pathways and Lymph Nodes: A CT Lymphangiography Cadaver Study2020

    • Author(s)
      Shinaoka Akira、Koshimune Seijiro、Suami Hiroo、Yamada Kiyoshi、Kumagishi Kanae、Boyages John、Kimata Yoshihiro、Ohtsuka Aiji
    • Journal Title

      Radiology

      Volume: 294 Issue: 1 Pages: 223-229

    • DOI

      10.1148/radiol.2019191169

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Correlations between Tracer Injection Sites and Lymphatic Pathways in the Leg2019

    • Author(s)
      Shinaoka Akira、Koshimune Seijiro、Yamada Kiyoshi、Kumagishi Kanae、Suami Hiroo、Kimata Yoshihiro、Ohtsuka Aiji
    • Journal Title

      Plastic and Reconstructive Surgery

      Volume: 144 Issue: 3 Pages: 634-642

    • DOI

      10.1097/prs.0000000000005982

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Detailed Vascular Anatomy and Flap Harvest Technique of the Serratus Anterior/Rib Composite Flap2019

    • Author(s)
      Matsumoto H, Shinaoka A, Ohtsuka A, Kimata Y
    • Journal Title

      Plast Reconstr Surg

      Volume: 143 Issue: 1 Pages: 115-124

    • DOI

      10.1097/prs.0000000000005087

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Presentation] 下肢リンパ浮腫におけるリンパ流の解剖学的変化と臨床的意義2020

    • Author(s)
      品岡 玲、上山 和代、山田 潔、木股 敬裕
    • Organizer
      リンパ学会総会 2020
    • Related Report
      2020 Annual Research Report
    • Invited
  • [Presentation] リンパの遭遇の歴史、浮腫の評価方法、そしてICG-LG序章2019

    • Author(s)
      木股敬裕、品岡玲、山田潔
    • Organizer
      第4回リンパ浮腫治療学会
    • Related Report
      2019 Annual Research Report
    • Invited

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Published: 2019-04-18   Modified: 2024-01-30  

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