Application of contrast-enhanced ultrasound combined with ultrahigh-frequency ultrasound in lymphaticovenous anastomosis

Q: What clinical problem does the study address in LVA planning?

Successful LVA requires preoperative identification of functional lymphatic vessels and accurate measurement of their internal diameters; current single imaging approaches struggle to localize functional LVs and measure diameters accurately at the same time.

Q: How were patients grouped in the retrospective study?

Twenty-four female patients with secondary extremity lymphedema underwent three localization methods: CEUS combined with UHFUS (Group A), CEUS alone (Group B), and UHFUS alone (Group C).

Q: What is the main finding about the combined CEUS+UHFUS approach?

The combined approach rapidly located more functional LVs and also measured LV internal diameters more accurately than either CEUS alone or UHFUS alone, improving procedural efficiency.

Sep 30, 2026

Uploaded by Oliver

Secondary lymphedema severely affects quality of life, and lymphaticovenous anastomosis (LVA) depends on precise preoperative identification of functional lymphatic vessels (LVs) and accurate internal diameter measurement. This retrospective study evaluates whether combining contrast-enhanced ultrasound (CEUS) with ultrahigh-frequency ultrasound (UHFUS) improves functional LV localization and diameter quantification compared with CEUS alone or UHFUS alone. In 24 female patients, CEUS located more functional LVs faster, while UHFUS measured diameters more accurately; the combined approach delivered both benefits, streamlining LVA and improving efficiency.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background and clinical need

Imaging modalities for lymphatic vessels

Study aim and methods

Patient cohort and localization groups

Comparison metrics (localization and diameter)

Results and comparative findings

CEUS vs UHFUS vs combined CEUS+UHFUS

Interpretation and clinical implications

Abbreviations

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Application of contrast-enhanced ultrasound combined with ultrahigh-frequency ultrasound in lymphaticovenous anastomosis Xing Huang1,7, Yuanyan Tang2,7, Zhongzeng Liang3,7, Jia Zhu4, Xiaoting Yu4, Caigang Liu5,6 & Zhengren Liu4􀀍 Preoperative identification of functional lymphatic vessels (LVs) and accurate measurement of their internal diameters can facilitate lymphaticovenous anastomosis (LVA) . However, current single imaging methods cannot accurately measure LVs internal diameters while locating functional LVs. This study aims to demonstrate the accuracy and effectiveness of combining contrast-enhanced ultrasound (CEUS) with ultra-high-frequency ultrasound (UHFUS) for precisely locating functional LVs and measuring internal diameters. 24 patients with secondary upper or lower extremity lymphedema were included in this retrospective study, who underwent three localization methods respectively: CEUS combined with UHFUS (Group A), CEUS alone (Group B), and UHFUS alone (Group C) . 24 patients were all female (mean age, 61.9 ± 7.1 years [SD]). Compared with UHFUS, CEUS can locate more functional LVs more quickly (3.00 (2.00,3.00) number vs. 5.88 ± 1.25 number, P < 0.001b, 36.43 ± 8.62 min/each vs. 8.45 ± 4.25 min/each, P < 0.001b ) . UHFUS can measure internal diameters of LVs more accurately compared toCEUS (0.10(0.10,0.10) mm vs. 0.30(0.20,0.34) mm, P< 0.001b ) . Compared with CEUS alone, CEUS combined with UHFUS can measure internal diameters of LVs more accurately on the basis of quickly locating functional LVs (0.10 (0.10,0.10) mm vs. 0.30(0.20,0.34) mm P < 0.001b ) . CEUS combined with UHFUS can locate more functional LVs more quickly compared to UHFUS alone (5 .25 ± 0.89 number vs. 3.00 (2 .00,3 .00) number, P < 0.001b, 9.88 ± 4.21 min/each vs. 36.43 ± 8.62 min/ each, P < 0.001b ). The integrated approach combined the advantages of both CEUS and UHFUS. It can not only rapidly localize functional LVs, but also accurately measure internal diameters, which streamlines LVA and improves efficiency. Keywords Contrast-enhanced ultrasound, Ultrahigh-frequency ultrasonographic, Lymphaticovenous anastomosis, Contrast enhanced ultrasound combined with ultra-high frequency ultrasound Abbreviations LVs lymphatic vessels LVA lymphaticovenous anastomosis TVs target veins CEUS contrast-enhanced ultrasound UHFUS ultra-high frequency ultrasound ICG Indocyanine green MRI magnetic resonance imaging ISL lymphatic Society stage 1Department of Ultrasound Medicine, Affiliated Hospital of Guangdong Medical University, Guangdong, China. 2Nanchang University, Nanchang, China. 3Department of Breast Surgery, Affiliated Hospital of Guangdong Medical University, Guangdong, China. 4Department of Breast Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China. 5Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China. 6Cancer Stem Cell and Translational Medicine Laboratory, Shengjing Hospital of China Medical University, Shenyang, China. 7These authors contributed equally: Xing Huang,Yuanyan Tang and Zhongzeng Liang. 􀀍 email: [Lzr0926@sina.com](Lzr0926@sina.com) [www. nature.com/scientificreports/](www. nature.com/scientificreports/) Secondary lymphedema significantly impairs patients’ quality of life, leading to substantial physical discomfort and psychological distress1,2. Conservative treatments for lymphedema include compression therapy and limb elevation, while surgical options include procedures such as lymph node transfer surgery, and lymphaticovenous anastomosis (LVA)3–5. The main objective of LVA is not only to restore lymphatic fluid drainage in the affected area but also to re-establish physiological lymphatic circulation, thereby optimizing the residual lymphatic function to the greatest extent possible6. LVA has been proven to be an effective treatment for

FAQs

What clinical problem does the study address in LVA planning?

Successful LVA requires preoperative identification of functional lymphatic vessels and accurate measurement of their internal diameters; current single imaging approaches struggle to localize functional LVs and measure diameters accurately at the same time.

How were patients grouped in the retrospective study?

Twenty-four female patients with secondary extremity lymphedema underwent three localization methods: CEUS combined with UHFUS (Group A), CEUS alone (Group B), and UHFUS alone (Group C).

What is the main finding about the combined CEUS+UHFUS approach?

The combined approach rapidly located more functional LVs and also measured LV internal diameters more accurately than either CEUS alone or UHFUS alone, improving procedural efficiency.

Sep 30, 2026

Uploaded by Oliver