{"title":"Non-contrast magnetic resonance imaging-based evaluation of quality of life in secondary upper extremity lymphedema.","authors":"Takashi Kageyama, Toko Miyazaki, Hayahito Sakai, Reiko Tsukuura, Takumi Yamamoto","doi":"10.1016/j.jvsv.2025.102220","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Non-contrast magnetic resonance imaging (NMRI) has emerged as an efficient tool for evaluating fluid infiltration in upper extremity lymphedema (UEL). This study aimed to examine the relationship between quality of life (QOL) in UEL and regional fluid infiltration on NMRI.</p><p><strong>Method: </strong>A single-center retrospective observational study was conducted involving 65 patients with secondary UEL who underwent NMRI and ICG-L between 2017 and 2021. The presence of NMRI findings (Reticular, Thin stripe, Thick stripe, Multiple stripes, and Honeycomb) in six regions of the upper arm and the NMRI stage were compared to Lymphedema Quality of Life Score (LeQOLiS), Quick Disabilities of the Arm, Shoulder and Hand (DASH) scores, the indocyanine green lymphography (ICG-L) stage, International Society of Lymphology (ISL) stage, and UEL index.</p><p><strong>Results: </strong>NMRI patterns were observed in 276/390 regions (70.8%) of 62/65 patients (95.4%). Thin stripe was most significantly associated with the greatest number of items (7/10) constituting the LeQOLiS score. Thick stripe had the most significant relationships with heaviness (r<sub>s</sub> = 0.40, P < .001) and distention (r<sub>s</sub> = 0.29, P = .021), while Multiple stripes had the most significantly associated with the appearance distortion (r<sub>s</sub> = 0.37, P = .002). The hand localization of Thin stripe was significantly correlated with worsening of the greatest number of 7/11 items in Quick DASH, while the upper arm localization of Thin stripe was related with 4/10 LeQOLiS items. The higher NMRI stage was significantly associated with the deterioration of the total score (P = .012) and six items in the LeQOLiS and two items in Quick DASH. The higher NMRI stage had significant correlations with the advancement of the ICG-L stage and UEL index (r<sub>s</sub> = 0.83, P < .001 and r<sub>s</sub> = 0.65, P < .001, respectively).</p><p><strong>Conclusion: </strong>The higher total number of Thin stripe in upper limbs has potentials as indicator of overall deterioration of QOL in UEL patients. The hand and upper arm localization of Thin stripe had significant associations with hand-related functional disability and lymphedema-specific symptoms, respectively.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102220"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of vascular surgery. Venous and lymphatic disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvsv.2025.102220","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Non-contrast magnetic resonance imaging (NMRI) has emerged as an efficient tool for evaluating fluid infiltration in upper extremity lymphedema (UEL). This study aimed to examine the relationship between quality of life (QOL) in UEL and regional fluid infiltration on NMRI.
Method: A single-center retrospective observational study was conducted involving 65 patients with secondary UEL who underwent NMRI and ICG-L between 2017 and 2021. The presence of NMRI findings (Reticular, Thin stripe, Thick stripe, Multiple stripes, and Honeycomb) in six regions of the upper arm and the NMRI stage were compared to Lymphedema Quality of Life Score (LeQOLiS), Quick Disabilities of the Arm, Shoulder and Hand (DASH) scores, the indocyanine green lymphography (ICG-L) stage, International Society of Lymphology (ISL) stage, and UEL index.
Results: NMRI patterns were observed in 276/390 regions (70.8%) of 62/65 patients (95.4%). Thin stripe was most significantly associated with the greatest number of items (7/10) constituting the LeQOLiS score. Thick stripe had the most significant relationships with heaviness (rs = 0.40, P < .001) and distention (rs = 0.29, P = .021), while Multiple stripes had the most significantly associated with the appearance distortion (rs = 0.37, P = .002). The hand localization of Thin stripe was significantly correlated with worsening of the greatest number of 7/11 items in Quick DASH, while the upper arm localization of Thin stripe was related with 4/10 LeQOLiS items. The higher NMRI stage was significantly associated with the deterioration of the total score (P = .012) and six items in the LeQOLiS and two items in Quick DASH. The higher NMRI stage had significant correlations with the advancement of the ICG-L stage and UEL index (rs = 0.83, P < .001 and rs = 0.65, P < .001, respectively).
Conclusion: The higher total number of Thin stripe in upper limbs has potentials as indicator of overall deterioration of QOL in UEL patients. The hand and upper arm localization of Thin stripe had significant associations with hand-related functional disability and lymphedema-specific symptoms, respectively.
期刊介绍:
Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.