Journal of vascular surgery. Venous and lymphatic disorders · 2025
Preliminary study on the application of contrast-enhanced ultrasound in lymphovenous anastomosis.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Wang Jing, Lu Min, Hu Mingxing, Li Liuyi, Zhang Kui, Li Xu
Аннотация
OBJECTIVE: To explore the value of lymphatic contrast-enhanced ultrasound (CEUS) in lymphovenous anastomosis (LVA), with a particular focus on its role in preoperative lymphatic localization.
METHODS: On the basis of whether preoperative ultrasound lymphatic contrast imaging was performed, the lymphatic diameter and depth from the skin were measured. Patients were divided into two groups: indocyanine green (ICG, 21 patients) and ICG combined with CEUS (21 patients). The differences between the two groups were compared in terms of total surgery time; number of anastomoses; anastomosis time per lymphatic vessel; and limb volume reduction at 1 week, 1 month, and 3 months postoperatively. A P value of < .05 was considered to indicate statistical significance.
RESULTS: In the ICG + CEUS group, the success rate of ultrasound contrast imaging was 95%. The average lymphatic diameter was 0.6 ± 0.2 mm, and the average depth from the skin was 5.3 ± 2.8 mm. Among these patients, 74% had lymphatic reflux, 55% had reflux into the dermis, and 36% had collateral vessel formation. Compared with the ICG group, the ICG + CEUS group had a significantly shorter total surgery time (320 ± 124 vs 398 ± 93 minutes; P = .005), shorter anastomosis time per lymphatic vessel (14 ± 2 vs 32 ± 15 minutes; P < .001), and more anastomoses (median 19 vs 12; P < .001). There were no significant differences between the two groups in terms of limb volume reduction at 1 week, 1 month, or 3 months postoperatively (P > .05).
CONCLUSIONS: CEUS can be a powerful supplement for locating lymphatic vessels before LVA.
METHODS: On the basis of whether preoperative ultrasound lymphatic contrast imaging was performed, the lymphatic diameter and depth from the skin were measured. Patients were divided into two groups: indocyanine green (ICG, 21 patients) and ICG combined with CEUS (21 patients). The differences between the two groups were compared in terms of total surgery time; number of anastomoses; anastomosis time per lymphatic vessel; and limb volume reduction at 1 week, 1 month, and 3 months postoperatively. A P value of < .05 was considered to indicate statistical significance.
RESULTS: In the ICG + CEUS group, the success rate of ultrasound contrast imaging was 95%. The average lymphatic diameter was 0.6 ± 0.2 mm, and the average depth from the skin was 5.3 ± 2.8 mm. Among these patients, 74% had lymphatic reflux, 55% had reflux into the dermis, and 36% had collateral vessel formation. Compared with the ICG group, the ICG + CEUS group had a significantly shorter total surgery time (320 ± 124 vs 398 ± 93 minutes; P = .005), shorter anastomosis time per lymphatic vessel (14 ± 2 vs 32 ± 15 minutes; P < .001), and more anastomoses (median 19 vs 12; P < .001). There were no significant differences between the two groups in terms of limb volume reduction at 1 week, 1 month, or 3 months postoperatively (P > .05).
CONCLUSIONS: CEUS can be a powerful supplement for locating lymphatic vessels before LVA.