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[下肢定量容积分析:与既定卷尺测量法和排水法的对比验证]

[Quantitative volumetric analysis of the lower extremity: validation against established tape measurement and water displacement].

作者信息

Koban Konstantin Christoph, Titze Virginia, Etzel Lucas, Frank Konstantin, Schenck Thilo, Giunta Riccardo

机构信息

Klinikum der Ludwig-Maximilians Universität, München Handchirurgie, Plastische Chirurgie, Äshetische Chirurgie.

出版信息

Handchir Mikrochir Plast Chir. 2018 Dec;50(6):393-399. doi: 10.1055/a-0770-3445. Epub 2019 Jan 8.

Abstract

BACKGROUND

Tape measures continue to be used for the diagnosis and evaluation of lipoedema and lymphoedema in the clinical routine. Extremity volumes are calculated based on standardised circumferential measurements. Other volume measurements such as water displacement are not applied on a regular basis. This study aimed to evaluate a 3D scanner as an alternative and reproducible tool to objectively measure the volumes of the lower extremity.

PATIENTS, MATERIALS AND METHOD: We used a commercially available 3D scanner, the Artec Eva, to perform 3D scans of the lower extremities on 20 subjects and calculated the volume using the appropriate software. In addition, limb volume was determined with standardised methods using the circumferential method (cone method and disc method) and the water displacement technique. The results and the time taken to perform the three measurement methods were documented and statistically evaluated.

RESULTS

There were no significant deviations between the results from 3D volumetry and water displacement (p > 0.05). The cone method significantly overestimated the volume measured by water displacement and 3D volumetry. The disc method revealed no statistically significant differences, but clinically relevant differences with a high variance in the 95 % confidence interval. All methods demonstrated high positive correlations with each other. Water displacement was the most timeconsuming method.

CONCLUSION

Our findings obtained from the examination of 40 lower extremities show that 3D scans and software-based volumetric calculations can achieve objective and reproducible measurements in a relatively short time. The deviation from the gold-standard method of water displacement is small. Compared with the cone and disc method, however, we observed clinically relevant deviations with a high variance. We therefore recommend the 3D scan procedure for the objective documentation of conservative and surgical treatments for lipoedema or lymphoedema and have incorporated it into our clinical routine.

摘要

背景

在临床实践中,卷尺仍被用于诊断和评估脂肪性水肿和淋巴水肿。肢体体积是根据标准化的周长测量值计算得出的。其他体积测量方法,如水置换法,并未得到常规应用。本研究旨在评估三维扫描仪作为一种客观测量下肢体积的替代且可重复的工具。

患者、材料与方法:我们使用一台商用三维扫描仪——爱泰克Eva,对20名受试者的下肢进行三维扫描,并使用相应软件计算体积。此外,采用标准化方法,通过周长法(圆锥法和圆盘法)和水置换技术测定肢体体积。记录三种测量方法的结果及所需时间,并进行统计学评估。

结果

三维容积测量法与水置换法的结果之间无显著偏差(p>0.05)。圆锥法显著高估了水置换法和三维容积测量法测得的体积。圆盘法在统计学上无显著差异,但在95%置信区间内存在具有临床意义的差异且方差较大。所有方法之间均显示出高度正相关。水置换法是最耗时的方法。

结论

我们对40条下肢的检查结果表明,三维扫描和基于软件的容积计算能够在相对较短的时间内实现客观且可重复的测量。与水置换这一金标准方法的偏差较小。然而,与圆锥法和圆盘法相比,我们观察到具有临床意义的偏差且方差较大。因此,我们推荐采用三维扫描程序对脂肪性水肿或淋巴水肿的保守和手术治疗进行客观记录,并已将其纳入我们的临床实践中。

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