Mengke Liu, Dingyuan Luo, Xingpeng Li, Yimeng Zhang, Rengui Wang
{"title":"原发性下肢淋巴水肿的 MRI 特征：对 228 例患者的回顾性分析。","authors":"Mengke Liu, Dingyuan Luo, Xingpeng Li, Yimeng Zhang, Rengui Wang","doi":"10.1016/j.jvsv.2024.102004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The value of MRI presentation of primary lower extremity lymphedema in assessing the severity of lower extremity lymphedema is uncertain. The purpose of this study was to assess the role of MRI presentation in staging primary lower extremity lymphedema.</p><p><strong>Methods: </strong>228 patients with clinically diagnosed primary lower limb lymphoedema from January 2018 to December 2019 in our hospital were enrolled retrospectively. Patients were divided into stages I, II, and III based on the 2020 International Society of Lymphology (ISL) clinical staging standards. Two radiologists assessed the following characteristics of the Short Term Inversion Recovery (STIR) sequence: the extent of edema (longitudinally and transversely), the frequency of MRI manifestations, including the presence of dermal thickening, and the morphology of edema (grid, honeycomb, parallel-lines, banded, crescent, and lymphatic lake). The Kappa test was used to assess interobserver agreement. The chi-square test was used to compare the frequency differences of MRI manifestations between different clinical stages. The Spearman test evaluated the correlation between edema extent and clinical stage.</p><p><strong>Results: </strong>The extent of edema was positively correlated with clinical stage, both longitudinally and transversely. When comparing stages, the incidence of dermal thickening in stages II and III was significantly higher than in stage I. The incidence of parallel-lines in stage I was significantly higher than that in stages II and III. The grid and banded sign incidence in stages I and II were significantly higher than in stage III. The incidence of honeycomb in stages II and III was significantly higher than in stage I. The incidence of lymphatic lake and crescent in stage III was significantly higher than in stages I and II (P<0.001).</p><p><strong>Conclusion: </strong>STIR can sensitively diagnose lymphedema and assist in clinical staging. MRI manifestations of primary lower extremity lymphedema in different stages have specific MRI features.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102004"},"PeriodicalIF":2.8000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"MRI features of primary lower extremity lymphedema: a retrospective analysis of 228 patients.\",\"authors\":\"Mengke Liu, Dingyuan Luo, Xingpeng Li, Yimeng Zhang, Rengui Wang\",\"doi\":\"10.1016/j.jvsv.2024.102004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The value of MRI presentation of primary lower extremity lymphedema in assessing the severity of lower extremity lymphedema is uncertain. The purpose of this study was to assess the role of MRI presentation in staging primary lower extremity lymphedema.</p><p><strong>Methods: </strong>228 patients with clinically diagnosed primary lower limb lymphoedema from January 2018 to December 2019 in our hospital were enrolled retrospectively. Patients were divided into stages I, II, and III based on the 2020 International Society of Lymphology (ISL) clinical staging standards. Two radiologists assessed the following characteristics of the Short Term Inversion Recovery (STIR) sequence: the extent of edema (longitudinally and transversely), the frequency of MRI manifestations, including the presence of dermal thickening, and the morphology of edema (grid, honeycomb, parallel-lines, banded, crescent, and lymphatic lake). The Kappa test was used to assess interobserver agreement. The chi-square test was used to compare the frequency differences of MRI manifestations between different clinical stages. The Spearman test evaluated the correlation between edema extent and clinical stage.</p><p><strong>Results: </strong>The extent of edema was positively correlated with clinical stage, both longitudinally and transversely. When comparing stages, the incidence of dermal thickening in stages II and III was significantly higher than in stage I. The incidence of parallel-lines in stage I was significantly higher than that in stages II and III. The grid and banded sign incidence in stages I and II were significantly higher than in stage III. The incidence of honeycomb in stages II and III was significantly higher than in stage I. The incidence of lymphatic lake and crescent in stage III was significantly higher than in stages I and II (P<0.001).</p><p><strong>Conclusion: </strong>STIR can sensitively diagnose lymphedema and assist in clinical staging. MRI manifestations of primary lower extremity lymphedema in different stages have specific MRI features.</p>\",\"PeriodicalId\":17537,\"journal\":{\"name\":\"Journal of vascular surgery. 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Venous and lymphatic disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvsv.2024.102004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
MRI features of primary lower extremity lymphedema: a retrospective analysis of 228 patients.
Background: The value of MRI presentation of primary lower extremity lymphedema in assessing the severity of lower extremity lymphedema is uncertain. The purpose of this study was to assess the role of MRI presentation in staging primary lower extremity lymphedema.
Methods: 228 patients with clinically diagnosed primary lower limb lymphoedema from January 2018 to December 2019 in our hospital were enrolled retrospectively. Patients were divided into stages I, II, and III based on the 2020 International Society of Lymphology (ISL) clinical staging standards. Two radiologists assessed the following characteristics of the Short Term Inversion Recovery (STIR) sequence: the extent of edema (longitudinally and transversely), the frequency of MRI manifestations, including the presence of dermal thickening, and the morphology of edema (grid, honeycomb, parallel-lines, banded, crescent, and lymphatic lake). The Kappa test was used to assess interobserver agreement. The chi-square test was used to compare the frequency differences of MRI manifestations between different clinical stages. The Spearman test evaluated the correlation between edema extent and clinical stage.
Results: The extent of edema was positively correlated with clinical stage, both longitudinally and transversely. When comparing stages, the incidence of dermal thickening in stages II and III was significantly higher than in stage I. The incidence of parallel-lines in stage I was significantly higher than that in stages II and III. The grid and banded sign incidence in stages I and II were significantly higher than in stage III. The incidence of honeycomb in stages II and III was significantly higher than in stage I. The incidence of lymphatic lake and crescent in stage III was significantly higher than in stages I and II (P<0.001).
Conclusion: STIR can sensitively diagnose lymphedema and assist in clinical staging. MRI manifestations of primary lower extremity lymphedema in different stages have specific MRI features.
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.
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