Division of General Surgery, Cancer Center, Department of Breast Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China.
Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China.
J Vasc Surg Venous Lymphat Disord. 2024 Sep;12(5):101907. doi: 10.1016/j.jvsv.2024.101907. Epub 2024 May 15.
Contrast-enhanced ultrasound (CEUS) is useful in mapping lymphatic vessels in upper limb lymphedema; this study was aimed to evaluate its efficiency in lower limb lymphedema and investigate whether magnetic resonance lymphangiography (MRL) enhance the efficiency of CEUS.
This retrospective study enrolled 48 patients with lymphedema undergoing lymphaticovenous anastomosis (LVA) surgery who received MRL and/or CEUS in addition to conventional indocyanine green (ICG) lymphangiography. The number of anastomotic sites and the duration per site (DPS) for LVA surgery were described and compared.
Among the 48 patients subjected to analysis, it was observed that 12 (25%), 20 (41.67%), and 16 (33.33%) of them received ICG, ICG+CEUS, and ICG+CEUS+MRL, respectively. The ICG+CEUS group demonstrated a significant increase in the number of LVAs (median, 5; range, 4-7), compared with the ICG group (median, 2; range, 1-4) (P < .001). Moreover, the ICG+CEUS+MRL group exhibited a higher number of LVAs (median, 8; range, 7-8.25) compared with both the ICG+CEUS and ICG groups (P < .001). For lower limb lymphedema, the ICG+CEUS+MRL group displayed an elevated number of LVAs (median, 8; interquartile range, 7-9) (P = .003), in contrast to the ICG group (median, 3; interquartile range, 1.75-4.25). Furthermore, the DPS in the ICG+CEUS+MRL group (median, 50.56; interquartile range, 48.13-59.29) (P = .005) exhibited a remarkable decrease when compared with the ICG group (median, 131.25; interquartile range, 86.75-198.13]).
MRL-CEUS fusion demonstrates superior performance in the identification of lymphatic vessels for lymphedema.
超声造影（CEUS）在描绘上肢淋巴水肿的淋巴管中很有用；本研究旨在评估其在下肢淋巴水肿中的效率，并研究磁共振淋巴造影（MRL）是否能提高 CEUS 的效率。
这项回顾性研究纳入了 48 例接受淋巴管静脉吻合术（LVA）的淋巴水肿患者，他们除了接受常规吲哚菁绿（ICG）淋巴造影外，还接受了 MRL 和/或 CEUS。描述并比较了 LVA 手术的吻合部位数量和每个部位的持续时间（DPS）。
在接受分析的 48 例患者中，分别有 12 例（25%）、20 例（41.67%）和 16 例（33.33%）接受了 ICG、ICG+CEUS 和 ICG+CEUS+MRL。与 ICG 组（中位数，2；范围，1-4）相比，ICG+CEUS 组的 LVA 数量显著增加（中位数，5；范围，4-7）（P<0.001）。此外，ICG+CEUS+MRL 组的 LVA 数量高于 ICG+CEUS 组和 ICG 组（中位数，8；范围，7-8.25）（P<0.001）。对于下肢淋巴水肿，与 ICG 组（中位数，3；范围，1.75-4.25）相比，ICG+CEUS+MRL 组的 LVA 数量增加（中位数，8；四分位距，7-9）（P=0.003）。此外，与 ICG 组（中位数，131.25；四分位距，86.75-198.13）相比，ICG+CEUS+MRL 组的 DPS（中位数，50.56；四分位距，48.13-59.29）显著降低（P=0.005）。
MRL-CEUS 融合在识别淋巴水肿的淋巴管方面表现出更好的性能。
