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Computed Tomography-Based Quantitative Analysis of Fibrotic Changes in Skin and Subcutaneous Tissue in Lower Extremity Lymphedema Following Gynecologic Cancer Surgery

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Author(s)
Dong Gyu LeeSoyoung LeeKyoung Tae Kim
Keimyung Author(s)
Lee, So YoungKim, Kyoung Tae
Department
Dept. of Rehabilitation Medicine (재활의학)
Journal Title
Lymphat Res Biol
Issued Date
2022
Volume
20
Issue
5
Keyword
lymphedemafibrosiscomputed tomographycellulitisquantitative analysis
Abstract
Background:
Lymphedema produces protein-rich fluids that aggravate inflammation in the skin and subcutaneous tissue. Inflammation then induces fibroadipose tissue deposition and fibrosis. However, few methods have been developed to evaluate the severity of fibrosis. Therefore, we aimed to evaluate the subcutaneous fibrotic changes in lower extremity lymphedema following gynecologic cancer surgery using an image analysis tool, the FIJI software.

Methods and Results:
Seventy-four patients with lymphedema following gynecologic surgery were enrolled in this study. We quantitatively analyzed the cross-sectional area (CSA) of soft tissue compartments, including subcutaneous tissue with the skin, muscle volume, fibrotic changes in subcutaneous tissue, and the perimeter of skin boundaries. The limb circumference and the CSA of the subcutaneous tissue and skin on the affected side were significantly larger than those on the unaffected side. Fibrotic changes showed the same trend. However, muscle volume patterns were different from those of the other compartments. Some patients showed lower muscle volume on the unaffected side than on the affected side. Circumference and cellulitis significantly affected the extent of fibrotic changes in the skin and subcutaneous tissues. Age and duration of lymphedema did not affect fibrosis.

Conclusion:
Fibrosis of subcutaneous regions with the skin can be quantitatively calculated using an image analysis tool in lower extremity lymphedema following gynecologic cancer surgery. Edema and cellulitis increase fibrotic changes in the subcutaneous tissue with the skin.
Keimyung Author(s)(Kor)
이소영
김경태
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1557-8585
Source
https://www.liebertpub.com/doi/10.1089/lrb.2021.0069
DOI
10.1089/lrb.2021.0069
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44691
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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