Abstract
BACKGROUND: Current single preoperative lymphatic imaging technique are inadequate to ensure the simplification and enhanced efficiency of lymphatic venous anastomosis (LVA) procedures. The application value of contrast-enhanced ultrasound (CEUS) examination combined with ultra-high-frequency ultrasound (UHFUS) examination in LVA has not been explored. This study aimed to systematically explore the clinical application value of CEUS examination integrated with UHFUS examination in guiding LVA. METHODS: Patients undergoing LVA after localization with indocyanine green (ICG) lymphography (group B) or CEUS examination combined with UHFUS examination (group A) from November 1, 2023, to March 1, 2025, were enrolled sequentially. Preoperative localization time and number of lymphatic vessels (LVs), skin incision length, time and number of LVs anastomoses during LVA, postoperative reduction in the maximum circumference of the affected limb, and improvement in subjective symptoms were compared. RESULTS: A total of 19 patients with lymphedema who underwent LVA were included in our study. Compared with indocyanine green, CEUS combined with UHFUS examination can shorten preoperative LVs localization time, increase the number of end-to-end anastomoses during LVA, streamline the LVA procedure, and improve patient symptoms to some extent. CONCLUSIONS: CEUS combined with UHFUS examination is a promising method for the preoperative evaluation of LVs that can enhance the efficiency and feasibility of LVA.