Effects of lymphatic drainage on cellulitis assessed by magnetic resonance

The aim of this study was to assess the use of magnetic resonance as a new method for evaluating the manual lymphatic drainage technique in treating cellulitis. Cellulitis is one of the main esthetic problems that lead women toward seeking guidance and specific treatments. There are various therapeutic approaches, owing to the multi-factorial nature of its pathogen, although the effectiveness of most of these has not been definitively proven, given that the assessment methods used are mostly subjective or do not provide enough information on subcutaneous tissue. The introduction of magnetic resonance as a means of assessing a lymphatic drainage technique in cellulitis treatment makes the evaluation more accurate, since it enables a detailed study of subcutaneous architecture.

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Use of magnetic resonance imaging for evaluation of therapeutic response in breast cancer-related lymphedema: A systematic review

Archives of Plastic Surgery ◽

10.5999/aps.2020.00115 ◽

2020 ◽

Vol 47 (4) ◽

pp. 305-309

Author(s):

Antonio Jorge Forte ◽

Daniel Boczar ◽

Salam Kassis ◽

Maria T. Huayllani ◽

Sarah A. McLaughlin

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Therapeutic Response ◽

Chemical Exchange ◽

Lymphatic Drainage ◽

Chemical Exchange Saturation Transfer ◽

Manual Lymphatic Drainage ◽

Resonance Imaging

Breast cancer treatment-related lymphedema (BCRL) is a common comorbidity in breast cancer survivors. Although magnetic resonance imaging (MRI) is widely used to evaluate therapeutic response of patients with various medical conditions, it is not routinely used to evaluate lymphedema patients. We conducted a systematic review of the literature to identify studies on the use of MRI to evaluate therapy for BCRL. We hypothesized that MRI could provide information otherwise not possible through other examinations. On October 21, 2019, we conducted a systematic review on the PubMed/MEDLINE and Scopus databases, without time frame or language limitations, to identify studies on the use of MRI to evaluate therapy for BCRL. We excluded studies that investigated other applications of MRI, such as lymphedema diagnosis and surgical planning. Of 63 potential articles identified with the search, three case series fulfilled the eligibility criteria. In total, 53 patients with BCRL were included and quantitatively evaluated with MRI before and after manual lymphatic drainage. Authors used MRI or MR lymphagiography to investigate factors such as lymphatic vessel cross-sectional area, tissue water relaxation time (T<sub>2</sub>), and chemical exchange saturation transfer. The only study that compared MRI measurement with standard examinations reported that MRI added information to the therapy evaluation. MRI seems to be a promising tool for quantitative measurement of therapeutic response in patients with BCRL. However, the identified studies focused on only manual lymphatic drainage and were limited by the small numbers of patients. More studies are necessary to shed light on the topic.

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