Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190139
Jornal Vascular Brasileiro
Original Article

Uso de software na imagem ultrassonográfica para diferenciação de edema de origem venosa e de origem linfática em membros inferiores

Use of ultrasound imaging software to differentiate venous and lymphatic edema in lower limbs

Vanessa Lôbo de Carvalho; Guilherme Benjamin Brandão Pitta; Sérgio Xavier Salles Cunha

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Resumo

Resumo: Contexto: O edema de membros inferiores (MMII) possui causas de origem sistêmicas e locais. Uma inovação é a utilização de um software de caracterização tecidual para diferenciação da origem do edema em imagens de ultrassom.

Objetivos: Determinar os parâmetros do uso de software na imagem ultrassonográfica para diferenciação de edema de origem venosa e/ou linfática em MMII.

Métodos: Trata-se de um estudo transversal do tipo quantitativo analítico com amostragem não probabilística por conveniência. Os instrumentos de coleta foram: anamnese, exame físico, exame de ultrassom e análise do software de caracterização tecidual por imagem ultrassonográfica por meio da quantificação da ecogenicidade e da mediana da escala de cinza (GSM).

Resultados: A amostra foi composta por 42 MMII de edema venoso, 35 de edema linfático, 14 de edema misto e 11 controle. Quanto à distribuição dos pixels nos intervalos de ecogenicidade, o grupo com edema venoso apresentou 88,31% entre o intervalo hipoecogênico IV ao ecogênico III; o grupo com edema linfático, 71,73% entre o intervalo hipoecogênico II ao ecogênico I; grupo com edema misto, 76,17% entre o intervalo hipoecogênico III ao ecogênico II; e o grupo controle, 84,87% entre o intervalo ecogênico II ao hiperecogênico I. A média e o desvio-padrão da GSM apresentaram diferença estatística entre os grupos.

Conclusão: O software CATUS permitiu a diferenciação do tipo de edema de MMII, facilitando o diagnóstico do tipo de edema e, consequentemente, a escolha da melhor opção terapêutica.

Palavras-chave

linfedema, insuficiência venosa, ultrassom, software

Abstract

Background: Lower limb edema has both systemic and local causes. Using software to differentiate the origin of edema in ultrasound images is an innovation. Objective: To determine the parameters for using software to differentiate edema of venous and/or lymphatic origin in ultrasound images of the lower limbs. Method: This is a cross-sectional, quantitative, analytical study with non-probabilistic sampling by convenience. Data were collected by patient interview, physical examination, ultrasound examination, and analysis of software for tissue characterization in ultrasound image by means of quantification of echogenicity and Gray Scale Median (GSM). Results: The sample comprised 42 lower limbs with venous edema, 35 with lymphatic edema, 14 with mixed edema, and 11 control limbs. The distributions of pixels in echogenicity intervals by group was as follows. In the venous edema group, 88.31% were distributed from hypoechogenic interval IV to echogenic interval III; in the lymphatic edema group 71.73% were from hypoechogenic interval II to echogenic interval I; in the mixed edema group 76.17% were from hypoechogenic interval III to echogenic interval II; and in the control group 84.87% were distributed from echogenic interval II to hyperechogenic interval I. Mean and standard deviation of GSM values showed statistical differences between groups. Conclusion: The CATUS software enabled differentiation of the type of lower limb edema, facilitating diagnosis of edema type and, consequently, choice of the best therapeutic option.

Keywords

lymphedema; venous insufficiency; ultrasonics; software

References

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Submitted date:
11/13/2019

Accepted date:
06/18/2020

5fbfbfaf0e8825066bf5cc93 jvb Articles

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