Suehiro Kotaro, Morikage Noriyasu, Murakami Masanori, Yamashita Osamu, Ueda Koshiro, Samura Makoto, Nakamur Kaori, Hamano Kimikazu
Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Ann Vasc Dis. 2014;7(1):21-7. doi: 10.3400/avd.oa.13-00107. Epub 2014 Feb 4.
To elucidate the differences in subcutaneous ultrasound findings between dependent edema (DE) and secondary lower extremity lymphedema (LE).
Twenty legs in 10 patients with DE and 54 legs in 35 patients with LE, who first visited our clinic between April 2009 and December 2012, were studied retrospectively. Subcutaneous echogenicity and echo-free space (EFS) were assessed at 8 points on the thigh and leg using an 8-12 MHz ultrasound transducer.
In DE, echogenicity was increased most in the lower leg, without a difference between the medial and lateral side. The EFS was most remarkable in the lower leg, and the lateral side was more severe. In the early stages of LE, echogenicity was similarly increased in the medial thigh and in the leg, while remarkable EFS was observed only in the lower leg. As clinical severity progressed, echogenicity increased in all parts of the lower extremity. EFS also increased in all parts of the leg, but the lower leg was still the most severe.
Echogenicity seemed to progress differently in DE and LE, but EFS progressed similarly and according to gravity. The current ultrasound findings may have added some diagnostic value in differentiating these conditions.
阐明下垂性水肿（DE）与继发性下肢淋巴水肿（LE）在皮下超声检查结果上的差异。
回顾性研究了2009年4月至2012年12月期间首次就诊于我院的10例DE患者的20条腿以及35例LE患者的54条腿。使用8-12MHz超声探头在大腿和小腿的8个点评估皮下回声性和无回声间隙（EFS）。
在DE中，小腿的回声性增加最为明显，内侧和外侧之间无差异。EFS在小腿最为显著，且外侧更严重。在LE的早期，大腿内侧和小腿的回声性同样增加，而仅在小腿观察到明显的EFS。随着临床严重程度的进展，下肢所有部位的回声性均增加。腿部所有部位的EFS也增加，但小腿仍然最为严重。
DE和LE的回声性进展似乎不同，但EFS进展相似且与重力有关。目前的超声检查结果可能在鉴别这些疾病方面增加了一些诊断价值。
