Department of Physical Medicine and Rehabilitation, Izmir Tepecik Training and Research Hospital, Health Science University, Izmir, Turkey.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Lymphat Res Biol. 2021 Dec;19(6):517-523. doi: 10.1089/lrb.2020.0068. Epub 2021 Feb 18.
Many assessments have been reported and used in evaluating lymphedema. The aim of this study was to investigate the diagnostic contribution of ultrasonography in unilateral breast cancer-related lymphedema. Upper extremity circumferences were measured with a measuring tape from ulnar styloid at the wrist to the axilla at 4 cm intervals. The point with the highest difference between the upper extremities and the control point with no difference between the lower extremities were marked. Skin and subcutaneous thicknesses were measured from four quadrants (volar medial-lateral and dorsal medial-lateral) at the marked points and also subcutaneous tissue changes were graded according to the subcutaneous echogenicity grade (SEG) scale ultrasonographically. The correlations between circumferential and ultrasonographic measurements were investigated. Receiver operating characteristic curve analysis was made to estimate the diagnostic accuracy of the difference in ultrasonographic subcutaneous thickness measurements between the two arms. The study was completed with 34 female patients. Circumferential and subcutaneous tissue thickness measurements were moderately positively correlated in the volar quadrants and strongly positively correlated in the dorsal quadrants of the affected extremity. In the unaffected extremity, a strong positive correlation was identified in all quadrants. The clinical stages of lymphedema and SEG were weakly positively correlated in the volar medial quadrant. The difference between the two upper extremities was found to have a high (0.83%) sensitivity, and an acceptable (0.75%) specificity in the differentiation of Grade II and Grade III lymphedema. : A correlation was established between circumferential measurements and ultrasonographic measurements. Ultrasonography can be used complementary to circumferential measurements in diagnosing lymphedema. Clinical trial registration number: NCT04213001.
许多评估方法已被报道并用于评估淋巴水肿。本研究旨在探讨超声在单侧乳腺癌相关淋巴水肿中的诊断价值。使用卷尺从腕部尺骨茎突到腋窝每隔 4cm 测量上肢周径。标记上肢之间差异最大的点和下肢之间无差异的对照点。在标记点处从四个象限（掌侧内外侧和背侧内外侧）测量皮肤和皮下组织厚度，并根据皮下回声分级（SEG）超声分级评估皮下组织变化程度。研究了周径和超声测量之间的相关性。进行受试者工作特征曲线分析，以估计双臂超声皮下厚度测量差异的诊断准确性。该研究共纳入 34 名女性患者。受累上肢掌侧象限的周径和皮下组织厚度测量呈中度正相关，背侧象限呈强正相关。在未受累上肢，所有象限均呈强正相关。淋巴水肿的临床分期和 SEG 在掌侧内侧象限呈弱正相关。在区分 II 级和 III 级淋巴水肿时，双上肢之间的差异具有较高的（0.83%）敏感性和可接受的（0.75%）特异性。：周径测量与超声测量之间存在相关性。超声检查可作为周径测量的补充方法，用于诊断淋巴水肿。临床试验注册号：NCT04213001。
