OBJECTIVE We evaluated whether superficial lymphatic anatomy and functional lymph node drainage are symmetric between the right and left upper extremities of healthy female volunteers, and if handedness is associated with symmetry of superficial lymphatic anatomy. BACKGROUND Symmetry of lymphatic anatomy has been assumed historically. This assumption of individual anatomic symmetry is being utilized clinically and in research without validation. METHODS 36 normal female volunteers underwent bilateral indocyanine green (ICG) lymphography and lymphoscintigraphy of the upper extremities. Eight collecting vessel pathways of each upper extremity were mapped on ICG lymphography. 13 lymph node groups were visualized on lymphoscintigraphy. Symmetry of lymphatic anatomy and functional drainage were established by comparing the right and left extremities of each participant. Hand dominance was assessed by hand grip strength on a hand dynamometer. RESULTS Among the 36 participants, 10 (28%) showed symmetry of all eight upper extremity lymphatic pathways with ICG. However, only 1 (3%) participant demonstrated complete symmetry amongst the 13 lymph node groups. Total symmetry of lymphatic channels was observed on ICG in seven (39%) participants with hand dominance and three (17%) participants without hand dominance (X2 = 2.215, P = 0.137). CONCLUSION Lymphatic anatomy and functional drainage of the upper extremities are not consistently symmetric. Functional nodal drainage as demonstrated by lymphoscintigraphy shows less symmetry than anatomic studies of lymphatic channels using ICG. Symmetric lymphatic anatomy does not appear to correlate with hand dominance. These findings challenge the prevailing assumption of left-right lymphatic symmetry.

中文翻译：

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个体的上肢淋巴系统不对称：一项利用 ICG 淋巴造影和 SPECT/CT 淋巴闪烁显像的解剖学研究。


目的 我们评估了健康女性志愿者左右上肢的浅表淋巴解剖结构和功能性淋巴结引流是否对称，以及惯用手是否与浅表淋巴解剖结构的对称性相关。背景 历史上一直假设淋巴解剖结构的对称性。这种个体解剖对称性的假设正在临床和研究中使用，但未经验证。方法 36 例正常女性志愿者行双侧吲哚菁绿 （ICG） 淋巴造影和上肢淋巴闪烁显像。在 ICG 淋巴照片上绘制每个上肢的 8 条集合血管通路。在淋巴闪烁显像上可见 13 个淋巴结组。通过比较每个参与者的左右肢体来建立淋巴解剖结构和功能性引流的对称性。通过在手部测力计上评估手部握力来评估手部优势。结果 在 36 名参与者中，10 名 （28%） 显示所有 8 条上肢淋巴通路与 ICG 对称。然而，在 13 个淋巴结组中，只有 1 名 （3%） 参与者表现出完全对称。在 ICG 上观察到 7 名 （39%） 手部优势参与者和 3 名 （17%） 没有手部优势的参与者 （X2 = 2.215，P = 0.137） 的淋巴管完全对称。结论 淋巴解剖结构和上肢的功能性引流并不一致对称。淋巴闪烁显像显示的功能性淋巴结引流比使用 ICG 的淋巴管解剖学研究更不对称。对称淋巴解剖结构似乎与手部优势无关。这些发现挑战了左右淋巴对称性的普遍假设。