Pirri Carmelo, Pirri Nina, Ferraretto Chiara, Bonaldo Lara, De Caro Raffaele, Masiero Stefano, Stecco Carla
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy.
Department of Medicine-DIMED, School of Radiology, Radiology Institute, University of Padova, 35122 Padova, Italy.
Diagnostics (Basel). 2024 Nov 29;14(23):2697. doi: 10.3390/diagnostics14232697.
BACKGROUND/OBJECTIVES: Lymphedema, a common source of disability among oncology patients, necessitates continuous targeted rehabilitation. Recent studies have revealed the role of connective tissue in this pathology; however, despite existing research on ultrasound (US) use in lymphedema, no studies have specifically addressed the use of ultrasound to assess fasciae in patients with lymphedema. This study aims to provide a more objective characterization of typical US alterations in these patients by quantifying the thickness of superficial and deep fasciae and comparing them with those of healthy volunteers.
A cross-sectional study was performed using US imaging to measure the thickness of superficial and deep fascia in different regions and levels of the arm and forearm in a sample of 50 subjects: 25 chronic lymphedema patients and 25 healthy participants.
No significant difference in fascial thickness was observed between affected and unaffected upper limbs, but patients had notably thinner superficial fascia and deep fascia compared with healthy volunteers. The findings for superficial and deep fascia revealed statistically significant differences ( < 0.0001) in all regions and levels.
This study demonstrates the effectiveness of US imaging as a non-invasive tool for detecting subtle fascial changes in chronic lymphedema patients, revealing thinner fasciae compared with those in healthy volunteers. These findings suggest a potential anatomical predisposition to lymphedema, highlighting the importance of incorporating detailed US assessments in diagnosis and management to improve early intervention and patient outcomes. Future studies could, therefore, investigate whether preventive fascia assessment might improve the early identification of individuals at risk.
背景/目的：淋巴水肿是肿瘤患者常见的致残原因，需要持续的针对性康复治疗。最近的研究揭示了结缔组织在这种病理状况中的作用；然而，尽管已有关于超声（US）用于淋巴水肿的研究，但尚无研究专门探讨超声在评估淋巴水肿患者筋膜方面的应用。本研究旨在通过量化浅表和深部筋膜的厚度，并将其与健康志愿者的厚度进行比较，更客观地描述这些患者典型的超声改变。
采用横断面研究，利用超声成像测量50名受试者（25名慢性淋巴水肿患者和25名健康参与者）手臂和前臂不同区域及水平的浅表和深部筋膜厚度。
患侧和未患侧上肢的筋膜厚度无显著差异，但与健康志愿者相比，患者的浅表筋膜和深部筋膜明显更薄。浅表和深部筋膜的测量结果在所有区域和水平均显示出统计学显著差异（<0.0001）。
本研究证明了超声成像作为一种无创工具在检测慢性淋巴水肿患者细微筋膜变化方面的有效性，显示出与健康志愿者相比更薄的筋膜。这些发现提示了淋巴水肿潜在的解剖学易感性，突出了在诊断和管理中纳入详细超声评估以改善早期干预和患者预后的重要性。因此，未来的研究可以探讨预防性筋膜评估是否能改善对高危个体的早期识别。
