目的 探讨基于超声造影的淋巴管分型为肢体淋巴管-静脉吻合术（LVA）提供解剖学依据。 方法 前瞻性纳入25例继发性肢体淋巴管水肿患者，入组后行超声造影检查并根据其不同表现进行淋巴管分型，于LVA术前及术后对84个手术部位进行超高频超声成像评价淋巴管内淋巴液流动情况，并比较不同淋巴管分型对于手术疗效的影响。 结果 术前淋巴管超声造影不同分型在LVA术后吻合口通畅性存在一定差异。 结论 基于超声造影的淋巴管分型及辅助定位技术能显著提升LVA手术的精准性。
Objective To explore the anatomical basis based on ultrasound angiography (CEUS) for limb lymphatic vessel venous anastomosis (LVA). Methods Twenty-five patients with secondary lymphatic vessel edema were prospectively included, 84 surgical sites before and after LVA operation, and the influence of different lymphatic vessel classification on surgical efficacy was compared. Results There was some differences in anastomotic patency after LVA. Conclusion The lymphocyte classification and auxiliary positioning technique based on CEUS can significantly improve the accuracy and therapeutic effect of LVA surgery.
[1] 易梅, 张超, 刘旭东, 等.剪切波弹性成像定量评估下肢淋巴水肿的临床价值[J]. 中国超声医学杂志, 2023, 39(9):1056-1059. DOI：10.3969/j.issn.1002-0101.2023.09.032
[2] 刘勇, 邵敬, 王萤萤, 等. 超声造影成像下肢浅表淋巴管的初步研究[J]. 中国超声医学杂志, 2020, 36(10): 946-949. DOI：CNKI:SUN:ZGCY.0.2020-10-025
[3] 黄颖敏, 廖剑艺, 陈智毅. 超声技术用于乳腺癌相关淋巴水肿研究进展[J]. 中国医学影像技术,2021(11):1748-1750. DOI: 10.13929/j.issn.1003-3289.2021.11.038.
[4] 闫丽芳, 苏畅.下肢淋巴水肿的超声诊断价值[J]. 实用医技杂志, 2021(4): 460-461. DOI: 10.19522/j.cnki.1671-5098.2021.04.006.
[5] 王伟杰. 彩色多普勒超声诊断下肢淋巴水肿的临床价值[J]. 中国医药指南, 2012(8): 489-490. DOI: 10.15912/j.cnki.gocm.2012.08.127.
[6] Sanderson J, Tuttle N, Laakso L. Acoustic radiation force impulse elastography assessment of lymphoedema tissue: an insight into tissue stiffness[J]. Cancers, 2022,14(21):5281. DOI: 10.3390/cancers 14215281.
[7] Hara H, Mihara M. Ultrasound-guided lymphaticovenous anastomosis without indocyanine green lymphography mapping: a preliminary report[J]. Microsurgery, 2023, 43(3):238-244. DOI: 10.1002/micr.30959.
[8] van Heumen S, Riksen JJM, Bramer WM, et al.Imaging of the lymphatic vessels for surgical planning: a systematic review.[J]. Annals of surgical oncology, 2023, 30(1):462-479. DOI: 10.1245/s10434-022-12552-7.
京ICP备08002354号-3
