郭佳, 沈文彬, 信建峰, 等. CT评价继发性下肢淋巴水肿分级的价值研究[J]. CT理论与应用研究, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 引用本文: 郭佳, 沈文彬, 信建峰, 等. CT评价继发性下肢淋巴水肿分级的价值研究[J]. CT理论与应用研究, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 GUO J, SHEN W B, XIN J F, et al. Evaluation of CT imaging in secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039. (in Chinese) Citation: GUO J, SHEN W B, XIN J F, et al. Evaluation of CT imaging in secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 . (in Chinese) 郭佳, 沈文彬, 信建峰, 等. CT评价继发性下肢淋巴水肿分级的价值研究[J]. CT理论与应用研究, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 引用本文: 郭佳, 沈文彬, 信建峰, 等. CT评价继发性下肢淋巴水肿分级的价值研究[J]. CT理论与应用研究, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 GUO J, SHEN W B, XIN J F, et al. Evaluation of CT imaging in secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039. (in Chinese) Citation: GUO J, SHEN W B, XIN J F, et al. Evaluation of CT imaging in secondary lower extremity lymphedema: A prospective study[J]. CT Theory and Applications, 2022, 31(2): 237-243. DOI: 10.15953/j.ctta.2021.039 . (in Chinese) 作者简介:

郭佳：女，首都医科大学附属北京世纪坛医院住院医师，主要从事淋巴系统疾病的影像学诊断，E-mail： [email protected]

董健：男，首都医科大学附属北京世纪坛医院副主任医师，主要从事循环及淋巴系统疾病的影像学诊断，E-mail： [email protected]

中图分类号: R  814

目的：探讨CT双下肢体积测量法在继发性下肢淋巴水肿分级评价中的应用价值。材料及方法：收集2019年6月至2020年1月因继发性下肢淋巴水肿入院并行CT双下肢扫描的患者，临床医师于CT扫描一周内完成双下肢多径线实体测量，分别记录CT双下肢体积测量法及临床多径线测量法所得双侧全下肢、大腿及小腿的体积。基于患侧比健侧体积增大的百分比，分别得到CT和临床测量结果的全下肢、大腿及小腿的淋巴水肿分级，采用Kappa软件分析CT与临床全下肢淋巴水肿分级之间的一致性。结果：最终入组患者38例。CT双下肢体积测量法和临床多径线测量法所得患侧的全下肢体积分别为（9984±2217）cm ³ 和（11308±2373）cm ³ ，健侧分别为（7154±1417）cm ³ 和（8265±1704）cm ³ 。全下肢淋巴水肿的CT分级为隐匿期1例，轻度6例，中度14例，重度17例；临床分级为隐匿期1例，轻度8例，中度11例，重度18例。CT与临床分级的一致性非常好（Kappa=0.878）。结论：CT双下肢体积测量可以作为继发性下肢淋巴水肿分级诊断的影像检查工具。

CT /  下肢淋巴水肿 / Abstract: Objective: To explore the application value of CT bilateral lower extremity volume measurement in the grading of secondary lower extremity lymphedema. Materials and methods: Patients with secondary lower extremity lymphedema who were admitted to our hospital and underwent CT of both lower extremities were collected from June 2019 to January 2020. The clinician completed the multiple-circumference measurement of lower extremity within one week of CT scanning, and recorded the volumes of both lower extremities, thighs and calfs obtained by CT bilateral lower extremity volume measurement and clinical multiple-circumference method, respectively. Based on the percentage enlargement in the volume of the affected side compared with the healthy side, the grading of the whole lower extremity, thigh and calf was obtained by CT and clinical measurement results,respectively. Kappa analysis was used to compare the consistency between CT and clinical in the grading of whole lower extremity. Results: Thirty-eight patients were finally enrolled. The volumes of lower extremities measured respectively by CT bilateral lower extremity volume measurement and clinical multiple-circumference method were (cm ³ ): the affected side (9984±2217 and 11308±2373), the healthy side (7154±1417 and 8265±1704). The CT grading of whole lower extremity was 1 case in preclinical stage, 6 cases of mild, 14 cases of moderate, and 17 cases of severe. The clinical grading of whole lower extremity was 1 case in preclinical stage, 8 cases of mild, 11 cases of moderate, and 18 cases of severe. The consistency between CT and clinical in grading of whole lower extremity is excellent (Kappa=0.878). Conclusion: CT bilateral lower extremity volume measurement can be used as an imaging tool in the grading of secondary lower extremity lymphedema.

Key words: CT /  lower extremity lymphedema /  grade  The image of clinical multiple-circumference for both lower extre-mities. The black line is the cross section selected by the clinician. From bottom to top, it is ankle, lower 1/3 of calf, 1/2 of calf, and upper 1/3 of calf, Knee, lower 1/3 of thigh, 1/2 of thigh, upper 1/3 of thigh, and the root of thigh

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