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

Öz

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.

Anahtar Kelimeler

• 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

Kaynakça

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