Meme kanseri ilişkili lenfödemde lenfödem şiddeti ve elastografi ile ölçülen biseps kası sertliği arasında bir korelasyon var mı?

Year 2018, , 143 - 147, 30.11.2018

Hülya Aslan , Pınar Doruk Analan , Emine Kaya

https://doi.org/10.25000/acem.432532

Abstract

Amaç: Meme kanseri ilişkili lenfödem (MKİL) etkilenen el ve kolda şişme,
ağırlık hissi, katılık, ağrı, uyuşukluk ve hareket kısıtlılığına neden olur.
MKİL bu olgularda fibrozis, selülüt, lenfadenit ve sepsise yatkınlık yapar. Bu
çalışmanın amacı biseps kasında “makaslama dalgası elastografi” (SWE) ile
ölçülen sertlik ve lenfödem şiddeti arasındaki korelasyonu değerlendirmektir.

Yöntemler: Üst ekstremitede MKİL olan 20 olgu (ortalama yaş; 54,6±5,4 yıl) prospektif olarak çalışmaya dâhil edilmiştir. Biseps kası
sertliği SWE ile değerlendirilmiştir. Her bir olguda etkilenen taraftaki biseps
kasında “makaslama dalgası” hız değerleri ölçülmüştür.

Lenfödem şiddetine
lenfödemden etkilenen tarafla etkilenmeyen taraf arasındaki hacim ve çap farkı
hesaplanılarak karar verilmiştir.  Her
olguda biseps kasında “Shear Wave” hız değeri (SWH) ölçülmüştür. SWE ile
ölçülen biseps kası sertliği ve etkilenen tarafla etkilenmeyen taraf arasındaki
hacim ve çap farkları arasındaki korelasyon değerlendirilmiştir.

Bulgular: Etkilenen kolda
biseps kasında ölçülen SWH değerleri ile etkilenen ve etkilenmeyen
ekstremiteler arasındaki hacim ve çap farkı arasında orta derecede bir korelasyon
saptanmıştır (0,70≥ r≥ 0,51).

Sonuç: Çalışmamızda lenfödem şiddeti
arttıkça biseps kası sertliğinde artış olduğunu gösterdik. SWE ile ölçülen
biseps kası sertliği MKİL tanılı olgularda takipte kullanılabilecek kantitatif
bir metot olabilir.

Keywords

Lenfödem, elastografi, meme kanseri, biseps

: Is there a correlation between the biceps brachii muscle stiffness measured by elastography and severity of lymphedema in patients with breast cancer-related lymphedema?

Abstract

Aim: Breast-cancer-related lymphedema (BCRL) causes
symptoms such as swelling, heaviness, tightness, firmness, pain, numbness, or
impaired mobility in the affected arm and hand. It also predisposes patients to
fibrosis, cellulitis, infections, lymphadenitis, and septicemia. Aim of this
study was to analyze correlation between the biceps brachii muscle
stiffness measured by shear wave elastography (SWE) and severity of the
lymphedema.

Methods: This prospective study included 20 consecutive
patients (mean age, 54.6±5.4 years) with having BCRL in the upper limb. Stiffness
of the biceps brachii muscle was assessed by SWE. Shear wave speeds (SWS) of
the biceps muscle on the affected side for each patient were measured. Severity
of the lymphedema was determined by difference between diameters and
volumes of affected and unaffected extremities. Correlations between the
biceps brachii muscle stiffness measured by SWE and difference between diameters
and volumes of affected and unaffected extremities were analyzed.

Results: SWS of the biceps muscle on the affected side
showed positive fair correlation with difference between diameters and volumes
of affected and unaffected extremities (0.70≥ r≥ 0.51).

Conclusion: Our
results suggest that the biceps muscle stiffness increases with increase in severity
of lymphedema. The biceps muscle stiffness measured by SWE could provide a
quantitative tool for following-up patients with BCRL.

Keywords

Lymphedema, elastography, breast cancer, biceps brachii

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