Hayashi Akitatsu, Giacalone Guido, Yamamoto Takumi, Belva Florence, Visconti Giuseppe, Hayashi Nobuko, Handa Mayumi, Yoshimatsu Hidehiko, Salgarello Marzia
Breast Center, Kameda Medical Center, Chiba, Japan.
Department of Lymphatic Surgery, AZ Sint-Maarten Hospital, Duffel, Belgium.
Plast Reconstr Surg Glob Open. 2019 Jan 22;7(1):e2086. doi: 10.1097/GOX.0000000000002086. eCollection 2019 Jan.
Identification and localization of functional lymphatic vessels are important for lymphaticovenular anastomosis. Conventional high-frequency ultrasound (CHFUS) has been reported to be useful for them, but it has some disadvantages. In this article, we present new capabilities of ultra high-frequency ultrasound (UHFUS) for imaging of the lymphatic vessels, which may overcome the weakness of CHFUS.
Thirty unaffected extremities in 30 unilateral secondary lymphedema patients (13 upper limbs and 17 lower limbs) were examined. Identification of the lymphatic vessels using UHFUS and CHFUS were performed at 3 sites in each unaffected extremity. Number and diameter of the detected lymphatic vessels were compared between UHFUS and CHFUS groups. At the same time, new characteristics of the lymphatic vessels seen with UHFUS were investigated.
One hundred sixty-nine lymphatic vessels were detected with UHFUS, and 118 lymphatic vessels with CHFUS. The number of lymphatic vessels found in upper and lower extremities was significantly larger with UHFUS than with CHFUS. The diameter of lymphatic vessels found in upper and lower extremities was significantly smaller with UHFUS than with CHFUS. All lymphatic vessels that were detected in UFHUS were less likely to collapse when the transducer was against the skin of the examined sites.
Detection rate of the lymphatic vessels in nonlymphedematous extremities with UHFUS was higher than that with CHFUS. UHFUS provides images with extremely high resolution, demonstrating new characteristics of the lymphatic vessels.
功能性淋巴管的识别与定位对于淋巴管静脉吻合术至关重要。据报道,传统高频超声(CHFUS)对此有用,但存在一些缺点。在本文中,我们展示了超高频率超声(UHFUS)在淋巴管成像方面的新能力,这可能克服CHFUS的不足。
对30例单侧继发性淋巴水肿患者的30条未受影响的肢体(13条上肢和17条下肢)进行检查。在每个未受影响的肢体的3个部位使用UHFUS和CHFUS识别淋巴管。比较UHFUS组和CHFUS组检测到的淋巴管数量和直径。同时,研究用UHFUS观察到的淋巴管的新特征。
UHFUS检测到169条淋巴管,CHFUS检测到118条淋巴管。UHFUS在上肢和下肢发现的淋巴管数量明显多于CHFUS。UHFUS在上肢和下肢发现的淋巴管直径明显小于CHFUS。当换能器贴近检查部位的皮肤时,UFHUS检测到的所有淋巴管不太容易塌陷。
UHFUS对非淋巴水肿肢体淋巴管的检测率高于CHFUS。UHFUS提供具有极高分辨率的图像,展示了淋巴管的新特征。