Skip to content
2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
file format text download EPUB
file format pdf download PDF
side by side viewer icon HTML

Abstract

Background

Various methods have been employed to evaluate secondary limb lymphedema, each with its own set of limitations.

Objectives

To delve into a novel approach to lymphatic grading, specifically utilizing enhanced ultrasound for assessing lymphatic function, to compensate for the shortcomings of other methods to some extent.

Materials and Methods

The clinical and ultrasound data of 51 patients with secondary limb lymphedema from June 2022 to September 2023 were retrospectively analyzed. The characteristic ultrasound manifestations of all visualized lymphatic vessels were studied. A contrast-enhanced ultrasound grading of lymphatic vessels (Ceus-Clv) was formulated and applied to grade the 51 patients. The study also correlated Ceus-Clv with Campisi clinical stage, postoperative duration, and duration of edema.

Results

Out of 51 patients, there were 19 cases of Ceus-Clv I, 10 cases of Ceus-Clv II, 19 cases of Ceus-Clv III, and 3 cases of Ceus-Clv IV. The correlation coefficient (rs) between Ceus-Clv and Campisi clinical stages was 0.958 (P < 0.001). Similarly, the correlation coefficient between Ceus-Clv and postoperative duration was 0.824 (P < 0.001), and between Ceus-Clv and duration of edema was 0.763 (P < 0.001).

Conclusion

Ceus-Clv grading is a safe, convenient, and effective method for assessing lymphatic vessel function in secondary limb edema. This method can accurately reflect the patient's lymphatic vessel function and the severity of edema, providing valuable guidance for the treatment of secondary limb edema.

© 2025 The Author(s). Published by Bentham Science Publishers.
This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056354068250415084500
2025-04-30
2025-10-31

  • From This Site

    /content/journals/cmir/10.2174/0115734056354068250415084500
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

/deliver/fulltext/cmir/21/1/CMIR-21-E15734056354068.html?itemId=/content/journals/cmir/10.2174/0115734056354068250415084500&mimeType=html&fmt=ahah

References

  1. ZouL. LiuF. ShenP. HuY. LiuX. XuY. PenQ. WangB. ZhuY. TianY. The incidence and risk factors of related lymphedema for breast cancer survivors post-operation: A 2-year follow-up prospective cohort study.Breast Cancer201825330931410.1007/s12282‑018‑0830‑329397555
     [Google Scholar]
  2. WarrenA.G. BrorsonH. BorudL.J. SlavinS.A. Lymphedema: A comprehensive review.Ann. Plast. Surg.200759446447210.1097/01.sap.0000257149.42922.7e17901744
     [Google Scholar]
  3. SahaM. EdmondsE. MartinJ. BunkerC.B. Penile lymphoedema in association with asymptomatic Crohn’s disease.Clin. Exp. Dermatol.2009341889010.1111/j.1365‑2230.2008.02762.x19076802
     [Google Scholar]
  4. McLaughlinS.A. WrightM.J. MorrisK.T. SampsonM.R. BrockwayJ.P. HurleyK.E. RiedelE.R. Van ZeeK.J. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: Patient perceptions and precautionary behaviors.J. Clin. Oncol.200826325220522610.1200/JCO.2008.16.376618838708
     [Google Scholar]
  5. Abu-RustumN.R. AlektiarK. IasonosA. LevG. SonodaY. AghajanianC. ChiD.S. BarakatR.R. The incidence of symptomatic lower-extremity lymphedema following treatment of uterine corpus malignancies: A 12-year experience at Memorial Sloan-Kettering Cancer Center.Gynecol. Oncol.2006103271471810.1016/j.ygyno.2006.03.05516740298
     [Google Scholar]
  6. ChengM.H. PappalardoM. LinC. KuoC.F. LinC.Y. ChungK.C. Validity of the novel taiwan lymphoscintigraphy staging and correlation of cheng lymphedema grading for unilateral extremity Lymphedema.Ann. Surg.2018268351352510.1097/SLA.000000000000291730004927
     [Google Scholar]
  7. CemalY. PusicA. MehraraB.J. Preventative measures for lymphedema: Separating fact from fiction.J. Am. Coll. Surg.2011213454355110.1016/j.jamcollsurg.2011.07.00121802319
     [Google Scholar]
  8. GärtnerR. MejdahlM.K. AndersenK.G. EwertzM. KromanN. Development in self-reported arm-lymphedema in Danish women treated for early-stage breast cancer in 2005 and 2006 – A nationwide follow-up study.Breast201423444545210.1016/j.breast.2014.03.00124721743
     [Google Scholar]
  9. TartaglioneG. ViscontiG. BartolettiR. GentileschiS. SalgarelloM. RubelloD. CollettiP.M. Stress lymphoscintigraphy for early detection and management of secondary limb lymphedema.Clin. Nucl. Med.201843315516110.1097/RLU.000000000000196329293136
     [Google Scholar]
  10. KimG. SmithM.P. DonohoeK.J. JohnsonA.R. SinghalD. TsaiL.L. MRI staging of upper extremity secondary lymphedema: Correlation with clinical measurements.Eur. Radiol.20203084686469410.1007/s00330‑020‑06790‑032221682
     [Google Scholar]
  11. YamamotoT. YamamotoN. DoiK. OshimaA. YoshimatsuH. TodokoroT. OgataF. MiharaM. NarushimaM. IidaT. KoshimaI. Indocyanine green-enhanced lymphography for upper extremity lymphedema: A novel severity staging system using dermal backflow patterns.Plast. Reconstr. Surg.2011128494194710.1097/PRS.0b013e3182268cd921681123
     [Google Scholar]
  12. NagyB.I. MohosB. TzouC.H.J. Imaging modalities for evaluating lymphedema.Medicina20235911201610.3390/medicina5911201638004065
     [Google Scholar]
  13. LiuM. LiuS. ZhaoQ. CuiY. ChenJ. WangS. Using the indocyanine green (ICG) lymphography to screen breast cancer patients at high risk for lymphedema.Diagnostics202212498310.3390/diagnostics1204098335454031
     [Google Scholar]
  14. ImaiH. YoshidaS. MeseT. RohS. FujitaA. SasakiA. NagamatsuS. KoshimaI. Correlation between lymphatic surgery outcome and lymphatic image-staging or clinical severity in patients with lymphedema.J. Clin. Med.20221117497910.3390/jcm1117497936078909
     [Google Scholar]
  15. ZeltzerA.A. AnzarutA. HamdiM. A review of lymphedema for the hand and upper-extremity surgeon.J. Hand Surg. Am.201843111016102510.1016/j.jhsa.2018.03.05429789187
     [Google Scholar]
  16. CampisiC. BoccardoF. Microsurgical techniques for lymphedema treatment: Derivative lymphatic-venous microsurgery.World J. Surg.200428660961310.1007/s00268‑004‑7252‑415366754
     [Google Scholar]
  17. HaraH. MiharaM. Lymphaticovenous anastomosis for advanced‐stage lower limb lymphedema.Microsurgery202141214014510.1002/micr.3068933421191
     [Google Scholar]
  18. MiharaM. HaraH. KawasakiY. MitsuhashiT. OrikasaH. AndoH. NaitoM. Lymphatic venous anastomosis and complex decongestive therapy for lymphoedema: Randomized clinical trial.Br. J. Surg.20241111znad37210.1093/bjs/znad37237997932
     [Google Scholar]
  19. ForteA.J. KhanN. HuayllaniM.T. BoczarD. SaleemH.Y. LuX. ManriqueO.J. CiudadP. McLaughlinS.A. Lymphaticovenous anastomosis for lower extremity lymphedema: A systematic review.Indian J. Plast. Surg.202053101702410.1055/s‑0040‑170937232367914
     [Google Scholar]
  20. HayashiA. YamamotoT. YoshimatsuH. HayashiN. FuruyaM. HarimaM. NarushimaM. KoshimaI. Ultrasound visualization of the lymphatic vessels in the lower leg.Microsurgery201636539740110.1002/micr.2241425854520
     [Google Scholar]
  21. Czedik-EysenbergM. SteinbacherJ. ObermayerB. YoshimatsuH. HaraH. MiharaM. TzouC.H.J. MengS. Exclusive use of ultrasound for locating optimal LVA sites—A descriptive data analysis.J. Surg. Oncol.20201211515610.1002/jso.2572831612513
     [Google Scholar]
  22. HaraH. MiharaM. Ultrasound‐guided lymphaticovenous anastomosis without indocyanine green lymphography mapping: A preliminary report.Microsurgery202343323824410.1002/micr.3095936172988
     [Google Scholar]
  23. MiharaM. HaraH. KawakamiY. Ultrasonography for classifying lymphatic sclerosis types and deciding optimal sites for lymphatic-venous anastomosis in patients with lymphoedema.J. Plast. Reconstr. Aesthet. Surg.20187191274128110.1016/j.bjps.2018.05.01230173714
     [Google Scholar]
  24. JangS. LeeC.U. HesleyG.K. KnudsenJ.M. BrinkmanN.J. TranN.V. Lymphatic mapping using us microbubbles before lymphaticovenous anastomosis surgery for lymphedema.Radiology2022304121822410.1148/radiol.21235135380494
     [Google Scholar]
  25. XiahouY. YuanX. ZhuJ. HuW. ZhangL. The significance of contrast-enhanced ultrasound in the application of lymphaticovenous anastomosis.Curr. Med. Imaging202310.2174/011573405627362623112011221638031791
     [Google Scholar]
/content/journals/cmir/10.2174/0115734056354068250415084500
Loading
A Contrast-enhanced Ultrasound Grading of Lymphatic Vessels: A Correlative Study and A Therapeutic Suggestion to Secondary Limb Lymphoedema
Curr. Med. Imaging 21, e15734056354068 (2025); https://doi.org/10.2174/0115734056354068250415084500
/content/journals/cmir/10.2174/0115734056354068250415084500
/content/journals/cmir/10.2174/0115734056354068250415084500
Loading

Data & Media loading...


  • Article Type:     Research Article
Keyword(s): Contrast-enhanced ultrasound grading of lymphatic vessels; Function of lymphatic vessels; Indocyanine green; Lymphography; Postoperative tumor; Secondary limb lymphoedema

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test