Ultrasonographic findings and the clinical results of treatment for lymphedema.

We undertook this study using ultrasonography to examine structural changes occurring in the subcutaneous tissue with lymphedema. Ultrasonographic images were taken in 178 outpatients and 29 inpatients, with the images of the subcutis fluid accumulation, which was categorized into three types ( grade 0: absent, grade 1: a minimal amount of water, grade 2: stone-paved image due to excess water). Initial percentage of excess volume was correlated with the tissue fluid (grade 0: 7.5%, grade 1: 17.1%, grade 2: 30.5%, p <0.01). The higher the grade of fluid accumulation, the more important was the absolute reduction of lymphedema volume (grade 0: 2.5%, grade 1: 14.8%, grade 2: 33.2%, p <0.01). The percentage of severe lymphedema (stage2b + 3) was higher in inpatients than outpatients(89.3% vs. 45.8%), however, a significant decrease in the percentage of volume reduction was found for inpatients (29.4 ± 15.1% vs. 15.4 ± 14.2%, p <0.01). Echographic images can help to determine whether compression therapy will reduce lymphedema and to evaluate the treatment results by measuring tissue fluid. For severe lymphedema, a compression bandage was more effective than an elastic stocking. (English translation of Jpn J Phlebol 2013; 24: 287-294).