Hoffner Mattias, Peterson Pernilla, Månsson Sven, Brorson Håkan
1 Department of Clinical Sciences, Lund University , Malmö, Sweden .
2 Department of Surgery, Blekinge Hospital , Karlskrona, Sweden .
Lymphat Res Biol. 2018 Apr;16(2):174-181. doi: 10.1089/lrb.2017.0042. Epub 2017 Sep 28.
Lymphedema leads to adipose tissue deposition. Water-fat magnetic resonance imaging (MRI) can quantify and localize fat and water. The presence of excess fat and excess water/muscle in the subfascial compartment of the lymphedematous limb has not been investigated before. The aim of this study was to investigate epifascial and subfascial fat and water contents in patients with chronic lymphedema before and after liposuction.
Seven patients with arm lymphedema and six with leg lymphedema were operated on. The limbs were examined with water-fat MRI before liposuction (baseline) and at five time points. Complete reduction of the excess limb volumes was achieved. The excess epifascial fat was evident in the edematous limbs and a drop was seen following surgery. There were differences in excess water at all time points. At 1 year there was a decrease in excess water. Excess subfascial fat was seen in the edematous limbs at all time points. Subfascial excess water/muscle did not show any differences after surgery. However, starting from 3 months there was less subfascial water/muscle compared with baseline.
Subfascial fat in the lymphedematous limbs did not change. In contrast, the water in the subfascial compartment was reduced over time, which may represent a decrease of muscle volume after treatment due to less mechanical load after liposuction. Using water-fat MRI-based fat quantification, the fat and water contents may be quantified and localized in the various compartments in lymphedema.
淋巴水肿会导致脂肪组织沉积。水脂磁共振成像（MRI）能够对脂肪和水进行定量和定位。此前尚未对淋巴水肿肢体筋膜下间隙中多余脂肪和多余水/肌肉的存在情况进行研究。本研究的目的是调查慢性淋巴水肿患者在抽脂前后筋膜上和筋膜下的脂肪及水含量。
对7例上肢淋巴水肿患者和6例下肢淋巴水肿患者进行了手术。在抽脂前（基线）及五个时间点对肢体进行水脂MRI检查。实现了多余肢体体积的完全减小。水肿肢体中明显存在多余的筋膜上脂肪，术后可见其减少。在所有时间点，多余水分均存在差异。术后1年，多余水分减少。在所有时间点，水肿肢体中均可见多余的筋膜下脂肪。术后筋膜下多余的水/肌肉未见任何差异。然而，从术后3个月开始，与基线相比，筋膜下的水/肌肉减少。
淋巴水肿肢体的筋膜下脂肪未发生变化。相比之下，随着时间推移，筋膜下间隙中的水分减少，这可能代表抽脂后由于机械负荷减轻，治疗后肌肉体积减小。使用基于水脂MRI的脂肪定量方法，可以对淋巴水肿各间隙中的脂肪和水含量进行定量和定位。
