Hara Hisako, Mihara Makoto
Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2021 Mar 22;9(3):e3490. doi: 10.1097/GOX.0000000000003490. eCollection 2021 Mar.
Recently, there has been a growing interest in the use of lymphatic ultrasound in the preoperative investigation of lymphaticovenous anastomosis. The device used for the performance of lymphatic ultrasound varies among surgeons. In this case report, we compared several probes (18 MHz, 24 MHz, and 33 MHz linear probes) in 2 cases, to detect the lymphatic vessels in the lymphedematous limbs. In the upper limb lymphedema case, the lymphatic vessels were located at a depth of <5 mm. They could be better observed with the 33 MHz probe than with the 18 MHz probe. The probe with a high frequency (33 MHz) and high resolution seemed to be suitable for superficial layers <5 mm in depth. On the other hand, the probe of 33 MHz was not appropriate for the lymphedematous lower limb because the lymphatic vessels are usually located at around a depth of 1 cm. When comparing the 18 MHz and 24 MHz probes in observing the lymphatic vessels in the lower limb, the 24 MHz probe seemed more suitable because of its higher resolution. Among these options, the 33 MHz probe was suitable for lymphedematous upper limbs, and the 24 MHz probe was suitable for lymphedematous lower limbs.
最近,淋巴管超声在淋巴管静脉吻合术前检查中的应用越来越受到关注。不同外科医生用于淋巴管超声检查的设备各不相同。在本病例报告中,我们在2例患者中比较了几种探头(18兆赫、24兆赫和33兆赫线性探头),以检测淋巴水肿肢体中的淋巴管。在上肢淋巴水肿病例中,淋巴管位于深度<5毫米处。与18兆赫探头相比,使用33兆赫探头能更好地观察到淋巴管。高频(33兆赫)高分辨率探头似乎适用于深度<5毫米的浅层。另一方面,33兆赫探头不适用于下肢淋巴水肿,因为淋巴管通常位于约1厘米的深度。在比较18兆赫和24兆赫探头观察下肢淋巴管时,24兆赫探头因其更高的分辨率似乎更合适。在这些选择中,33兆赫探头适用于上肢淋巴水肿,24兆赫探头适用于下肢淋巴水肿。