Magnetic resonance lymphography demonstrates spontaneous lymphatic disruption and regeneration in obstructive lymphedema.

The present study was aimed at observing both the damage and change process undergone in lymphatic collectors in obstructive extremity lymphedema. Forty-five patients with obstructive extremity lymphedema who had been examined with magnetic resonance lymphangiography (MRL) were enrolled in the study. Among this group, 36 were diagnosed with secondary lymphedema of the lower extremity and 9 exhibited upper extremity lymphedema after mastectomy. Morphological damage as a result of obstruction of collecting lymph vessels was recorded and analyzed. Obvious damage to the lymph vessels was found in all of the 36 lower extremity lymphedema cases with different lengths of history, including vessel disruption in 21 and lymphatic regeneration in 15. Lymphatic damage occurred in the anterior tibial area of the lower leg in almost every case. In 9 cases with upper extremity lymphedema, collecting lymphatic disruption and lymph tracer leakage was seen in multiple patterns. Imaging displayed that ruptured lymph collectors healed spontaneously or regenerated into a segment of the lymphatic network. The present study provided real-time images of collecting lymphatic vessels in obstructive lymphedema. These were seen to have undergone disruption, displayed lymphorrhoea, and/or lymphatic regeneration. In addition, the images suggest that the anterior tibial lymphatic is the weak point of the lymphatic pathway in the lower limb.