PDF(Pubmed)
Abstract：
The pitting qualities of lymphoedema tissue change with disease progression. However, little is known about the underlying tissue response to the pitting test or the tissue characteristics that enhance or resist indentation. The pitting test is currently unstandardised, and the influence of test technique on pitting outcomes is unknown. Understanding how tissue reacts to applied pressure will build evidence for the standardisation of the pitting test. Ninety pitting test sites from fifteen women with unilateral breast cancer-related lymphoedema were evaluated using high-frequency ultrasound (HFUS), bioelectrical impedance spectroscopy (BIS), and limb volume measures. Three sites on each lymphoedema and non-lymphoedema arm were subject to a 60-s (s) staged pitting test, with changes in tissue features captured with ultrasound imaging before, throughout, and after the pitting test. Pitting qualities of tissues varied greatly, with lymphoedema sites pitting more frequently (p < 0.001) with greater depth (p < 0.001) and requiring a longer recovery time (p = 0.002) than contralateral unaffected tissue. Pitting is not solely attributable to oedema volume. Non-structural and structural characteristics of dermal and subcutaneous layers also influence tissue responses to sustained pressure. To enhance the validity and reliability of pitting assessment, a 60 s staged pitting test with an observation of tissue recovery is recommended for lymphoedema presentations.
摘要：
淋巴水肿组织的点蚀质量随疾病进展而变化。然而,对底层组织对点蚀试验的反应或增强或抵抗压痕的组织特征知之甚少。点蚀测试目前不标准化，测试技术对点蚀结果的影响未知。了解组织对施加的压力的反应将为点蚀测试的标准化建立证据。使用高频超声（HFUS）评估了15例单侧乳腺癌相关淋巴水肿女性的90个点蚀测试部位，生物电阻抗谱（BIS），和肢体体积测量。每个淋巴水肿和非淋巴水肿臂上的三个部位进行60s（s）分期点蚀试验，随着超声成像之前捕获的组织特征的变化，在整个过程中,在点蚀测试之后。组织的点蚀质量差异很大，与对侧未受影响的组织相比，淋巴水肿部位更频繁（p<0.001），深度更大（p<0.001），并且需要更长的恢复时间（p=0.002）。点蚀不仅仅归因于水肿体积。真皮和皮下层的非结构和结构特征也影响组织对持续压力的反应。为了增强点蚀评估的有效性和可靠性，对于淋巴水肿的表现，建议进行60s分期的点蚀试验，观察组织恢复。
