ORIGINAL RESEARCH article
Front. Surg.
Sec. Vascular Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1578436
High-frequency ultrasound combined with shear wave elastography to evaluate the efficacy of lymphaticovenular anastomosis in patients with secondary lymphedema
Provisionally accepted
- 1Xinxiang Medical University, Xinxiang, Henan Province, China
- 2Henan Provincial People's Hospital, Zhengzhou, China
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-frequency ultrasound combined with shear wave elastography to evaluate the efficacy of lymphaticovenular anastomosis in patients with secondary lymphedema 【Abstract】 Purpose: High-frequency ultrasound combined with shear wave elastography (SWE) was used to evaluate the efficacy of lymphaticovenular anastomosis (LVA) in treating secondary lymphedema. Materials and Methods: This study included 40 patients with secondary lymphedema who underwent LVA at the Department of Vascular Surgery, Henan Provincial People's Hospital, from October 2023 to October 2024. Limb circumference measurements, bioelectrical impedance analysis (BIA), and high-frequency ultrasound combined with SWE were conducted before and after treatment. Changes in subcutaneous echo-free space (SEFS) grading and elastic parameters were analyzed pre-and post-treatment.Results: Following LVA, the percentage of excess volume (PEV) and the extracellular water/total body water (ECW/TBW) ratio in the affected limb significantly decreased (P<0.001). SEFS scores of the subcutaneous tissue also showed statistically significant changes (P<0.001). Additionally, the shear wave velocity (SWV) of the dermis decreased, while that of the subcutaneous tissue layer increased, both with statistical significance (P<0.001). The difference in SEFS scores between pre-and post-treatment was statistically significant ( P < 0 . 0 0 1 ) , supporting the finding that SWV decreased in the dermis and increased in the subcutaneous tissue layer (P<0.001).The reduction in SEFS in the affected limb after LVA, along with the decreased SWV in the dermis and increased SWV in the subcutaneous tissue layer, suggests that LVA effectively reduces lymphatic fluid retention across all tissue layers. This provides novel ultrasonographic evidence for assessing and refining treatment efficacy and follow -up.
Keywords: Lymphedema, High-frequency ultrasound, Shear wave elastography, Lymphatic venous anastomosis, Subcutaneous echo-free space
Received: 13 Mar 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Zhang, Zhu, Xiao, wu, xu and song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haohui Zhu, Henan Provincial People's Hospital, Zhengzhou, China
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