Kleinhans et al described a transport index for patients undergoing lymphoscintigraphy. This can be used to monitor a patient over time. The authors are from the University of Munich.
Parameters:
(1) lymphatic transport kinetics (K)
(2) distribution pattern (D)
(3) time to appearance of lymph nodes (T)
(4) assessment of lymph nodes (N)
(5) assessment of lymph vessels (V)
|
Parameters |
Findings |
Points |
|
kinetics (K) |
no delay |
0 |
|
|
low grade delay |
3 |
|
|
extreme delay |
5 |
|
|
no (missing) transport |
9 |
|
distribution (D) |
normal distribution (nearly no background) |
0 |
|
|
partial diffuse (only in the surroundings of a knee) |
3 |
|
|
diffuse distribution |
5 |
|
|
transport stop |
9 |
|
time to appearance (T) |
first appearance of regional lymph nodes |
see below |
|
|
no appearance |
see below |
|
lymph nodes (N) |
clearly demonstrated |
0 |
|
|
faint visualization |
3 |
|
|
hardly recognizable |
5 |
|
|
no visualization |
9 |
|
lymph vessels (V) |
clearly demonstrable |
0 |
|
|
faint visualization |
3 |
|
|
hardly recognizable |
5 |
|
|
no visualization |
9 |
The points for time of appearance is not presented clearly. Based on the discussion on page 350 and the 2 examples given, my best guess is:
points for time of appearance =
= MIN(ROUND(0.04 * (time in minutes),0), 9)
where:
• 9 points is the assigned value for no appearance.
• The equation for the transport index includes the factor 0.04 times "T". Based on the examples given "T" seems to be the raw number of minutes to the first appearance of the regional lymph nodes. This interpretation is supported by the discussion in the right hand column.
transport index =
= (points for kinetics) + (points for distribution) + (points for time of appearance) + (points for lymph nodes) + (points for lymph vessels)
Interpretation:
• minimum transport index: 0
• maximum transport index: 45
• The higher the transport index the more severe the lymphatic disorder.
