Sonography of subcutaneous tissue cannot determine causes of lower limb edema.
Identifieur interne : 000C69 ( PubMed/Checkpoint ); précédent : 000C68; suivant : 000C70Sonography of subcutaneous tissue cannot determine causes of lower limb edema.
Auteurs : Mandy Becker [Allemagne] ; Tom Schilling [Allemagne] ; Olga Von Beckerath [Allemagne] ; Knut Kröger [Allemagne]Source :
- VASA. Zeitschrift fur Gefasskrankheiten [ 0301-1526 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Biais de l'observateur, Cardiopathies (), Diagnostic différentiel, Facteurs de risque, Femelle, Humains, Lymphoedème (imagerie diagnostique), Lymphoedème (étiologie), Maladies du foie (), Maladies vasculaires (), Membre inférieur (imagerie diagnostique), Mâle, Oedème (imagerie diagnostique), Oedème (étiologie), Reproductibilité des résultats, Sujet âgé, Sujet âgé de 80 ans ou plus, Valeur prédictive des tests, Échographie.
- MESH :
- imagerie diagnostique : Lymphoedème, Membre inférieur, Oedème.
- étiologie : Lymphoedème, Oedème.
- Adulte d'âge moyen, Biais de l'observateur, Cardiopathies, Diagnostic différentiel, Facteurs de risque, Femelle, Humains, Maladies du foie, Maladies vasculaires, Mâle, Reproductibilité des résultats, Sujet âgé, Sujet âgé de 80 ans ou plus, Valeur prédictive des tests, Échographie.
English descriptors
- KwdEn :
- Aged, Aged, 80 and over, Diagnosis, Differential, Edema (diagnostic imaging), Edema (etiology), Female, Heart Diseases (complications), Humans, Liver Diseases (complications), Lower Extremity (diagnostic imaging), Lymphedema (diagnostic imaging), Lymphedema (etiology), Male, Middle Aged, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Risk Factors, Ultrasonography, Vascular Diseases (complications).
- MESH :
- complications : Heart Diseases, Liver Diseases, Vascular Diseases.
- diagnostic imaging : Edema, Lower Extremity, Lymphedema.
- etiology : Edema, Lymphedema.
- Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Risk Factors, Ultrasonography.
Abstract
To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema.
DOI: 10.1024/0301-1526/a000418
PubMed: 25698390
Affiliations:
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pubmed:25698390Le document en format XML
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<term>Aged, 80 and over</term>
<term>Diagnosis, Differential</term>
<term>Edema (diagnostic imaging)</term>
<term>Edema (etiology)</term>
<term>Female</term>
<term>Heart Diseases (complications)</term>
<term>Humans</term>
<term>Liver Diseases (complications)</term>
<term>Lower Extremity (diagnostic imaging)</term>
<term>Lymphedema (diagnostic imaging)</term>
<term>Lymphedema (etiology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Observer Variation</term>
<term>Predictive Value of Tests</term>
<term>Reproducibility of Results</term>
<term>Risk Factors</term>
<term>Ultrasonography</term>
<term>Vascular Diseases (complications)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Biais de l'observateur</term>
<term>Cardiopathies ()</term>
<term>Diagnostic différentiel</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème (imagerie diagnostique)</term>
<term>Lymphoedème (étiologie)</term>
<term>Maladies du foie ()</term>
<term>Maladies vasculaires ()</term>
<term>Membre inférieur (imagerie diagnostique)</term>
<term>Mâle</term>
<term>Oedème (imagerie diagnostique)</term>
<term>Oedème (étiologie)</term>
<term>Reproductibilité des résultats</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Valeur prédictive des tests</term>
<term>Échographie</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Heart Diseases</term>
<term>Liver Diseases</term>
<term>Vascular Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Edema</term>
<term>Lower Extremity</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Edema</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lymphoedème</term>
<term>Membre inférieur</term>
<term>Oedème</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term>
<term>Oedème</term>
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<term>Aged, 80 and over</term>
<term>Diagnosis, Differential</term>
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<term>Humans</term>
<term>Male</term>
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<term>Observer Variation</term>
<term>Predictive Value of Tests</term>
<term>Reproducibility of Results</term>
<term>Risk Factors</term>
<term>Ultrasonography</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Biais de l'observateur</term>
<term>Cardiopathies</term>
<term>Diagnostic différentiel</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
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<front><div type="abstract" xml:lang="en">To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema.</div>
</front>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25698390</PMID>
<DateCreated><Year>2015</Year>
<Month>02</Month>
<Day>20</Day>
</DateCreated>
<DateCompleted><Year>2015</Year>
<Month>05</Month>
<Day>13</Day>
</DateCompleted>
<DateRevised><Year>2016</Year>
<Month>11</Month>
<Day>25</Day>
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<Article PubModel="Print"><Journal><ISSN IssnType="Print">0301-1526</ISSN>
<JournalIssue CitedMedium="Print"><Volume>44</Volume>
<Issue>2</Issue>
<PubDate><Year>2015</Year>
<Month>Mar</Month>
</PubDate>
</JournalIssue>
<Title>VASA. Zeitschrift fur Gefasskrankheiten</Title>
<ISOAbbreviation>VASA</ISOAbbreviation>
</Journal>
<ArticleTitle>Sonography of subcutaneous tissue cannot determine causes of lower limb edema.</ArticleTitle>
<Pagination><MedlinePgn>122-8</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1024/0301-1526/a000418</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema.</AbstractText>
<AbstractText Label="PATIENTS AND METHODS" NlmCategory="METHODS">38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers sign in those with positive and negative sign. The interpretation of the images was not different between both groups.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Becker</LastName>
<ForeName>Mandy</ForeName>
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<AffiliationInfo><Affiliation>Harzklinikum Wernigerode, Germany.</Affiliation>
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<Author ValidYN="Y"><LastName>Schilling</LastName>
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<AffiliationInfo><Affiliation>Harzklinikum Wernigerode, Germany.</Affiliation>
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<Author ValidYN="Y"><LastName>von Beckerath</LastName>
<ForeName>Olga</ForeName>
<Initials>O</Initials>
<AffiliationInfo><Affiliation>HELIOS Klinikum Krefeld, Germany.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Kröger</LastName>
<ForeName>Knut</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>HELIOS Klinikum Krefeld, Germany.</Affiliation>
</AffiliationInfo>
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<Language>eng</Language>
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<MedlineJournalInfo><Country>Switzerland</Country>
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<NlmUniqueID>0317051</NlmUniqueID>
<ISSNLinking>0301-1526</ISSNLinking>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004487" MajorTopicYN="N">Edema</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006331" MajorTopicYN="N">Heart Diseases</DescriptorName>
<QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008107" MajorTopicYN="N">Liver Diseases</DescriptorName>
<QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D035002" MajorTopicYN="N">Lower Extremity</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015588" MajorTopicYN="N">Observer Variation</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011237" MajorTopicYN="N">Predictive Value of Tests</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014463" MajorTopicYN="N">Ultrasonography</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014652" MajorTopicYN="N">Vascular Diseases</DescriptorName>
<QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName>
</MeshHeading>
</MeshHeadingList>
<OtherAbstract Type="Publisher" Language="ger"><AbstractText>Hintergrund: Um den klinischen Nutzen der Sonographie bei der Differenzierung von Ödemen zu untersuchen, haben wir die Frage gestellt, ob eine Gruppe von Ärzten Lymphödeme von kardialen, hepatischen oder venösen Ödemen nur durch die Analyse von Ultraschallbildern des Ödems unterscheiden kann. Patienten und Methoden: Es wurden 38 Patienten (Mittelwert ± SD: 70 ± 12 Jahre, 22 (58 %) Frauen) mit Ödemen der unteren Extremitäten rekrutiert. Nach der klinischen Diagnosestellung waren es 10 (26 %) Lymphödeme, 16 (42 %) Ödeme durch Herzinsuffizienz, 6 (16 %) durch Venenerkrankungen und 6 (16 %) durch eine chronische Lebererkrankung. Die Ödeme wurden sonographisch am schwerer betroffenen Bein standardisiert jeweils am distalen und am proximalen Unterschenkel dargestellt. 38 anonymisierte Bildsätze wurden 5 in der Sonographie erfahrenen Ärzten vorgelegt. Sie wurden gefragt, ob sie die Kriterien für ein Lymphödem sehen: 1. echoarme Spalten, 2. horizontale Lücken und 3. echoreiche Randsäume. Ergebnisse: Akzeptiert man das Ödem als Lymphödem, wenn nur ein Arzt mindestens eines der drei Kriterien eines lymphatischen Ödems auf jedem Einzelbild sieht, würden alle Ödeme als Lymphödem klassifiziert werden. Akzeptiert man ein Lymphödem nur, wenn alle Ärzte mindestens eines der drei Kriterien auf dem distalen Bild des gleichen Patienten sehen, werden 80 % der Patienten mit Lymphödem auch als solches klassifiziert, aber auch die Mehrheit der kardialen, venösen Ödeme und hepatischen Ödeme. Akzeptiert man ein Lymphödem nur, wenn alle Ärzte alle drei Kriterien im distalen Bild des gleichen Patienten sehen, würde keines der Ödeme als lymphatisch klassifiziert werden. Schlussfolgerungen: Unsere Analyse zeigt, dass es nicht möglich ist, Lymphödeme von anderen Ödemen der unteren Extremitäten sonographisch zu unterscheiden.</AbstractText>
</OtherAbstract>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Lymphedema</Keyword>
<Keyword MajorTopicYN="N">Stemmers sign</Keyword>
<Keyword MajorTopicYN="N">lower limb edema</Keyword>
<Keyword MajorTopicYN="N">sonography</Keyword>
</KeywordList>
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