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Lasso. Plast Aesthet Res 2020;7:30 I http://dx.doi.org/10.20517/2347-9264.2019.75 Page 7 of 12

Table 3. Fluorescence patterns are registered according to the images precepted 15 min after ICG injection
PRE-LVA fluorescence pattern POST-LVA fluorescence Baseline SPECT-CT/ Post LVA SPECT-CT/
pattern lymphoscintigraphy lymphoscintigraphy
1 Diffuse/stardust Stardust - -
2 Diffuse/stardust Diffuse/linear in some areas - ++
3 Diffuse/stardust Stardust - +
4 Stardust Linear - +*
5 Stardust Linear - +
6 Linear, stardust Linear - slow progression - +
7 Linear/stardust Linear - ++
8 Diffuse Diffuse - +
9 Stardust/splash Splash - +
10 Linear/splash Linear + +
11 Linear/stardust Linear - ++
12 Diffuse Diffuse - +
13 Splash Splash - -
14 Stardust Linear/splash - ++*
15 Diffuse/splash Splash - +
16 Diffuse Linear/diffuse - -
17 Linear/stardust Linear - ++
18 Stardust Stardust - +
19 Linear/splash Linear - +
20 Splash Splash - +
SPECT-CT/lymphoscintigraphy results are described at baseline and 1 year after lymphovenous anastomosis (LVA). Results are marked
as follows: -: No detectable migration of the tracer from the site of injection to the groin or axilla, lymphatic leakage or dermal backflow; +:
The report of new images of lymphatic flow along the limb; ++: The presence of lymph nodes at any point in the limb; *The presence of
extraanatomical lymphatic flow; Note that fluorescence patterns are detected 15 min after injection and SPECT-CT/lymphoscintigraphy
images are obtained 3 h after injection. This evaluation was performed the day before LVA and 1 year after it. Patterns are labeled
according to Yamamoto’s dermal backflow classification [11]

Figure 3. Pre-operative lympho-SPECT showing a lymph node at the root of the affected limb (left limb) that is smaller than the
contralateral one (blue arrow).