2024 Volume 40 Issue 1 Pages 36-42
We have reported the usefulness of lymphatic ultrasound using an 18 MHz linear probe (Noblus, Fuji Film). Degeneration of lymphatic vessels through ectasia, sclerosis, and obstruction occurs in lymphedema-affected limbs. Evaluation of lymphatic degeneration using ultrasonography has improved surgical outcomes for procedures such as lymphaticovenous anastomosis.
When identifying lymph vessels, we use the D-CUPS index to differentiate these vessels from veins, rather than use of color Doppler. The characteristics of the lymphatic vessels are defined as “cross” (passing through nearby veins), “uncollapsible” (do not collapse under pressure from the probe), “parallel” (multiple lymph vessels run in parallel), and located under the superficial fascia.
Lymphatic ultrasound is also useful for diagnosis of lymphatic function, as a minimally invasive examination that can be readily performed by medical staff. Conventional examinations of lymphatic function include lymphoscintigraphy and lymphangiography, but few medical centers can perform these methods. More widespread use of lymphatic ultrasound may lead to improved diagnosis and treatment of various diseases.
