Edematous Dermal Thickening on Magnetic Resonance Imaging as a Biomarker for Lymphatic Surgical Outcomes.
Edematous Dermal Thickening on Magnetic Resonance Imaging as a Biomarker for Lymphatic Surgical Outcomes.
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DOI：
10.3390/medicina59081369
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发表时间：
2023-07-26
影响因子：
2.6
通讯作者：
Tsai, Leo L.
中科院分区：
文献类型：
--
作者：
Kinney, JacqueLyn R.;Babapour, Sara;Kim, Erin;Friedman, Rosie;Singhal, Dhruv;Lee, Bernard T.;Tsai, Leo L.
背景和目的：乳癌相关性淋巴水肿的外科治疗方法之一是去脂肪切除术。这项研究的目的是调查真皮厚度是否可以作为去髓鞘术后变化的客观指标。材料和方法：对行去脂术的BCRL患者进行回顾性分析。由两个独立的训练有素的读数在上肢的16个区域测量了基于MRI的真皮厚度。对每个患者受累和未受累(对照)手臂手术前后真皮厚度的减少进行了比较。用Wilcoxon秩和检验评估有无显著变化。使用单变量线性回归分析真皮厚度减少与淋巴Q评分、L-德克斯评分和相对体积变化的关系。结果：17例患者进入我们的分析。患臂5/16区域真皮厚度明显减少。真皮厚度的变化与淋巴Q评分、L-Dex评分和2/16肢体间隔室的相对体积变化显著相关。真皮增厚主要见于上臂背侧和前臂腹侧和尺侧。结论：真皮厚度在跟踪乳腺癌相关淋巴水肿的术后清除过程中显示出良好的应用前景。需要对更大的患者群体和各种成像方式进行进一步的研究，以继续开发一种临床上客观和可重复性的手术后淋巴水肿分期和监测方法。
Background and Objectives: One of the surgical treatments for breast cancer-related lymphedema (BCRL) is debulking lipectomy. The aim of this study is to investigate whether dermal thickness could be utilized as an objective indicator of post-operative changes following debulking. Materials and Methods: A retrospective review of BCRL patients who underwent debulking lipectomy was conducted. MRI-based dermal thickness was measured by two separate trained readers at 16 regions of the upper extremity. Pre- and post-operative reduction in dermal thickness was compared across the affected and unaffected (control) arms for each patient. The Wilcoxon rank sum test was used to assess for significant change. Univariate linear regression was used to assess the relationship between dermal thickness reduction and changes to LYMPH-Q scores, L-Dex scores, and relative volume change. Results: Seventeen patients were included in our analysis. There was significant reduction in dermal thickness at 5/16 regions in the affected arm. Dermal thickness change was significantly correlated with LYMPH-Q scores, L-Dex scores, and relative volume change in 2/16 limb compartments. There was predominant dermal thickening in the dorsal compartment of the upper arm and in the ventral and ulnar compartments of the forearm. Conclusions: Dermal thickness shows promising utility in tracking post-operative debulking procedures for breast cancer-related lymphedema. Further studies with larger patient populations and a variety of imaging modalities are required to continue to develop a clinically objective and reproducible method of post-surgical lymphedema staging and monitoring.
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影响因子：
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作者：
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