Volume 42 Issue 3
Mar.  2026
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Tang ZY,Liu R,Deng CL.Research progress on the application of ultrasound technology in the diagnosis and treatment of lymphedema[J].Chin J Burns Wounds,2026,42(3):297-302.DOI: 10.3760/cma.j.cn501225-20250228-00104.
Citation: Tang ZY,Liu R,Deng CL.Research progress on the application of ultrasound technology in the diagnosis and treatment of lymphedema[J].Chin J Burns Wounds,2026,42(3):297-302.DOI: 10.3760/cma.j.cn501225-20250228-00104.

Research progress on the application of ultrasound technology in the diagnosis and treatment of lymphedema

doi: 10.3760/cma.j.cn501225-20250228-00104
Funds:

General Program of National Natural Science Foundation of China 82372541

Regional Science Foundation Project of National Natural Science Foundation of China 82260391, 82360448

More Information
  • Corresponding author: Deng Chengliang, Email: cheliadeng@zmu.edu.cn
  • Received Date: 2025-02-28
    Available Online: 2026-03-23
  • Lymphedema is a chronic progressive disease caused by abnormal development of the lymphatic system or lymphatic reflux disorder caused by congenital or acquired factors, early diagnosis and treatment of lymphedema are crucial for controlling the patient's condition. Traditional imaging methods (such as lymphoscintigraphy and magnetic resonance lymphography) have problems such as high cost, radiation exposure, or technical limitations in the diagnosis and evaluation of lymphedema. Ultrasound technology has become one of the core tools for diagnosis and treatment of lymphedema due to its advantages of non-invasive, real-time dynamic imaging, and repeatability. Therefore, we summarized the different characteristics of various ultrasound techniques for lymphedema in the diagnosis and treatment. Although ultrasound technology has significant advantages, there are still challenges such as operator dependence and limited deep tissue imaging. Doctors should select appropriate examination methods according to the specific conditions and characteristics of patients, so as to achieve the purpose of accurate diagnosis and selection of the best diagnosis and treatment plan.

     

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  • [1]
    LinWC, SafaB, BunticRF. Approach to lymphedema management[J]. Semin Plast Surg, 2022,36(4):260-273. DOI: 10.1055/s-0042-1758691.
    [2]
    SungC, WangS, HsuJ, et al. Current understanding of pathological mechanisms of lymphedema[J]. Adv Wound Care (New Rochelle), 2022,11(7):361-373. DOI: 10.1089/wound.2021.0041.
    [3]
    BrownS, DayanJH, KataruRP, et al. The vicious circle of stasis, inflammation, and fibrosis in lymphedema[J]. Plast Reconstr Surg, 2023,151(2):330e-341e. DOI: 10.1097/PRS.0000000000009866.
    [4]
    RocksonSG. Advances in lymphedema[J]. Circ Res, 2021,128(12):2003-2016. DOI: 10.1161/CIRCRESAHA.121.318307.
    [5]
    GniadeckaM. Localization of dermal edema in lipodermatosclerosis, lymphedema, and cardiac insufficiency. High-frequency ultrasound examination of intradermal echogenicity[J]. J Am Acad Dermatol, 1996,35(1):37-41. DOI: 10.1016/S0190-9622(96)90493-4.
    [6]
    de RezendeLF, PiloniJPM, KempaVL, et al. Ultrasonography as an instrument to evaluate lymphedema secondary to breast cancer: systematic review[J]. J Vasc Bras, 2023,22:e20220144. DOI: 10.1590/1677-5449.202201441.
    [7]
    TranBNN, CelestinAR, LeeBT, et al. Quantifying lymph nodes during lymph node transplantation: the role of intraoperative ultrasound[J]. Ann Plast Surg, 2018,81(6):675-678. DOI: 10.1097/SAP.0000000000001571.
    [8]
    ViscontiG, BianchiA, SalgarelloM, et al. Lymphatic tissue transfer: ultrasound-guided description and preoperative planning of vascularised lymph nodes, lymphatic units, and lymphatic vessels transfers[J]. J Pers Med, 2022,12(8):1346.DOI: 10.3390/jpm12081346.
    [9]
    陈宗灿, 陈君哲, 吴祥奎, 等. 血管化淋巴结移植联合淋巴静脉吻合术治疗乳腺癌根治术后单侧上肢淋巴水肿的临床效果[J].中华烧伤与创面修复杂志,2025,41(6):534-542. DOI: 10.3760/cma.j.cn501225-20250228-00105.
    [10]
    OmuraM, SaitoW, AkitaS, et al. In vivo quantitative ultrasound on dermis and hypodermis for classifying lymphedema severity in humans[J]. Ultrasound Med Biol, 2022,48(4):646-662. DOI: 10.1016/j.ultrasmedbio.2021.12.003.
    [11]
    PirriC, FerrarettoC, PirriN, et al. Ultrasound examination of skin, fasciae and subcutaneous tissue: optimizing rehabilitation for secondary upper limb lymphedema[J]. Diagnostics (Basel), 2024,14(24):1346. DOI: 10.3390/diagnostics14242824.
    [12]
    SonJH, MinJH, KimIH, et al. The clinical usefulness of ultrasonographic measurement technique in patients with lower extremity lymphedema[J]. Lymphat Res Biol, 2023,21(1):20-27. DOI: 10.1089/lrb.2021.0089.
    [13]
    ManderA, VenosiS, MenegattiE, et al. Upper limb secondary lymphedema ultrasound mapping and characterization[J]. Int Angiol, 2019,38(4):334-342. DOI: 10.23736/S0392-9590.19.04176-2.
    [14]
    HayashiA, GiacaloneG, YamamotoT, et al. Ultra high-frequency ultrasonographic imaging with 70 MHz scanner for visualization of the lymphatic vessels[J]. Plast Reconstr Surg Glob Open, 2019,7(1):e2086. DOI: 10.1097/GOX.0000000000002086.
    [15]
    BianchiA, ViscontiG, HayashiA, et al. Ultra-High frequency ultrasound imaging of lymphatic channels correlates with their histological features: a step forward in lymphatic surgery[J]. J Plast Reconstr Aesthet Surg, 2020,73(9):1622-1629. DOI: 10.1016/j.bjps.2020.05.053.
    [16]
    HaraH, MiharaM. Usefulness of 33 MHz linear probe in lymphatic ultrasound for lymphedema patients[J]. Lymphat Res Biol, 2023,21(4):366-371. DOI: 10.1089/lrb.2022.0054.
    [17]
    MiharaM, HaraH, KawakamiY. Ultrasonography for classifying lymphatic sclerosis types and deciding optimal sites for lymphatic-venous anastomosis in patients with lymphoedema[J]. J Plast Reconstr Aesthet Surg, 2018,71(9):1274-1281. DOI: 10.1016/j.bjps.2018.05.012.
    [18]
    HaraH, MiharaM. Screening lymphatic ultrasound to detect lymphatic dysfunction[J]. Lymphat Res Biol, 2025,23(2):64-70. DOI: 10.1089/lrb.2024.0064.
    [19]
    HayashiA, HayashiN, YoshimatsuH, et al. Effective and efficient lymphaticovenular anastomosis using preoperative ultrasound detection technique of lymphatic vessels in lower extremity lymphedema[J]. J Surg Oncol, 2018,117(2):290-298. DOI: 10.1002/jso.24812.
    [20]
    KimC, LeeC, QueirosI, et al. Noncontrast ultra-high-frequency ultrasound for preoperative lymphovenous mapping in patients undergoing lymphaticovenous anastomosis surgery for extremity lymphedema[J]. AJR Am J Roentgenol, 2025,224(3):e2432001. DOI: 10.2214/AJR.24.32001.
    [21]
    SchaverienMV, CoroneosCJ. Surgical treatment of lymphedema[J]. Plast Reconstr Surg, 2019,144(3):738-758. DOI: 10.1097/PRS.0000000000005993.
    [22]
    OgataF, AzumaR, KikuchiM, et al. Novel lymphography using indocyanine green dye for near-infrared fluorescence labeling[J]. Ann Plast Surg, 2007,58(6):652-655. DOI: 10.1097/01.sap.0000250896.42800.a2.
    [23]
    HaraH, MiharaM. Ultrasound-guided lymphaticovenous anastomosis without indocyanine green lymphography mapping: a preliminary report[J]. Microsurgery, 2023,43(3):238-244. DOI: 10.1002/micr.30959.
    [24]
    MohosB, Czedik-EysenbergM, SteinbacherJ, et al. Long-term use of ultrasound for locating optimal LVA sites: a descriptive data analysis[J]. J Reconstr Microsurg, 2022,38(3):238-244. DOI: 10.1055/s-0041-1740124.
    [25]
    SeverA, BroilletA, SchneiderM, et al. Dynamic visualization of lymphatic channels and sentinel lymph nodes using intradermal microbubbles and contrast-enhanced ultrasound in a swine model and patients with breast cancer[J]. J Ultrasound Med, 2010,29(12):1699-1704. DOI: 10.7863/jum.2010.29.12.1699.
    [26]
    JangS, BustosSS, ChenAD, et al. Lymphatic mapping with contrast-enhanced ultrasound for lymphaticovenous anastomosis surgery: how we do it[J]. Plast Reconstr Surg Glob Open, 2023,11(10):e5328. DOI: 10.1097/GOX.0000000000005328.
    [27]
    JangS, LeeCU, HesleyGK, et al. Lymphatic mapping using US microbubbles before lymphaticovenous anastomosis surgery for lymphedema[J]. Radiology, 2022,304(1):218-224. DOI: 10.1148/radiol.212351.
    [28]
    HaraH, MiharaM. Lymphaticovenous anastomosis map established using lymphatic ultrasound and multi-lymphosome indocyanine green lymphography[J]. J Plast Reconstr Aesthet Surg, 2024,94:223-228. DOI: 10.1016/j.bjps.2024.05.004.
    [29]
    LiY, TangJ, MaoD, et al. MRI-CEUS fusion-guided lymphatic mapping as a preoperative strategy for lymphedema patients undergoing lymphaticovenous anastomosis surgery[J]. J Vasc Surg Venous Lymphat Disord, 2024,12(5):101907. DOI: 10.1016/j.jvsv.2024.101907.
    [30]
    MoYW, LeeSJ, LeeDW, et al. Contrast-enhanced ultrasonography as an adjunctive method to ICG lymphography for functional lymphaticovenous anastomosis[J]. J Surg Oncol, 2024,129(5):965-974. DOI: 10.1002/jso.27576.
    [31]
    邓呈亮, 陈君哲, 肖顺娥, 等. 基于算法浅谈继发性下肢淋巴水肿的外科整合治疗[J].中华烧伤与创面修复杂志,2025,41(6):516-524. DOI: 10.3760/cma.j.cn501225-20250217-00067.
    [32]
    YuXH, YuanXC, ZhuJ, et al. The significance of contrast-enhanced ultrasound in the application of lymphaticovenous anastomosis[J/OL]. Curr Med Imaging, 2023(2023-11-29)[2025-02-28]. https://pubmed.ncbi.nlm.nih.gov/38031791/. DOI: 10.2174/0115734056273626231120112216.[published online ahead of print].
    [33]
    JangS, RamesJD, HesleyGK, et al. Randomized feasibility study evaluating multiple FDA-approved microbubbles for CEUS lymphography[J]. Plast Reconstr Surg Glob Open, 2024,12(7):e5985. DOI: 10.1097/GOX.0000000000005985.
    [34]
    KimHB, JungSS, ChoMJ, et al. Comparative analysis of preoperative high frequency color Doppler ultrasound versus MR lymphangiography versus ICG lymphography of lymphatic vessels in lymphovenous anastomosis[J]. J Reconstr Microsurg, 2023,39(2):92-101. DOI: 10.1055/s-0042-1745745.
    [35]
    CowanR, MannG, SalibianAA. Ultrasound in microsurgery: current applications and new frontiers[J]. J Clin Med, 2024,13(12):3412. DOI: 10.3390/jcm13123412.
    [36]
    SekiY, KajikawaA, YamamotoT, et al. The dynamic-lymphaticovenular anastomosis method for breast cancer treatment-related lymphedema: creation of functional lymphaticovenular anastomoses with use of preoperative dynamic ultrasonography[J]. J Plast Reconstr Aesthet Surg, 2019,72(1):62-70. DOI: 10.1016/j.bjps.2018.09.005.
    [37]
    BianchiA, SalgarelloM, HayashiA, et al. Recipient venule selection and anastomosis configuration for lymphaticovenular anastomosis in extremity lymphedema: algorithm based on 1,000 lymphaticovenular anastomosis[J]. J Reconstr Microsurg, 2022,38(6):472-480. DOI: 10.1055/s-0041-1735836.
    [38]
    LiaoXH, TangW, JiYN, et al. Application of combined preoperative indocyanine green lymphography and ultrasonography for low-pressure vein localization in secondary lymphedema surgery for breast cancer[J]. Asian J Surg, 2024, 47(1): 289-295. DOI: 10.1016/j.asjsur.2023.08.121.
    [39]
    ViscontiG, HayashiA, BianchiA, et al. Lymphaticovenular anastomosis for advanced-stage peripheral lymphedema: expanding indication and introducing the hand/foot sign[J]. J Plast Reconstr Aesthet Surg, 2022,75(7):2153-2163. DOI: 10.1016/j.bjps.2022.02.012.
    [40]
    LongE, MaselliA, BarronS, et al. Applications of ultrasound in the postoperative period: a review[J]. J Reconstr Microsurg, 2022,38(3):245-253. DOI: 10.1055/s-0041-1740959.
    [41]
    Naeem KhanMN, AhmedA, ZafarI, et al. The diagnostic accuracy of carotid Doppler in detecting anechoic thrombus against CT angiography as the gold standard[J]. Cureus, 2022,14(7):e26951. DOI: 10.7759/cureus.26951.
    [42]
    SandersonJ, TuttleN, LaaksoL. Acoustic radiation force impulse elastography assessment of lymphoedema tissue: an insight into tissue stiffness[J]. Cancers (Basel), 2022,14(21):5281. DOI: 10.3390/cancers14215281.
    [43]
    ShinSU, LeeW, ParkEA, et al. Comparison of characteristic CT findings of lymphedema, cellulitis, and generalized edema in lower leg swelling[J]. Int J Cardiovasc Imaging, 2013,29Suppl 2:S135-S143. DOI: 10.1007/s10554-013-0332-5.
    [44]
    TassenoyA, De MeyJ, De RidderF, et al. Postmastectomy lymphoedema: different patterns of fluid distribution visualised by ultrasound imaging compared with magnetic resonance imaging[J]. Physiotherapy, 2011,97(3):234-243. DOI: 10.1016/j.physio.2010.08.003.
    [45]
    LeeDG, ChoJH. Can tissue stiffness measured using shear-wave elastography represent lymphedema in breast cancer?[J]. Lymphat Res Biol, 2022,20(6):607-611. DOI: 10.1089/lrb.2021.0099.
    [46]
    BokSK, JeonY, LeeJA, et al. Evaluation of stiffness in postmastectomy lymphedema using acoustic radiation force impulse imaging: a prospective randomized controlled study for identifying the optimal pneumatic compression pressure to reduce stiffness[J]. Lymphat Res Biol, 2018,16(1):36-42. DOI: 10.1089/lrb.2016.0048.
    [47]
    Erdogan IyigunZ, AgacayakF, IlgunAS, et al. The role of elastography in diagnosis and staging of breast cancer-related lymphedema[J]. Lymphat Res Biol, 2019,17(3):334-339. DOI: 10.1089/lrb.2018.0012.
    [48]
    PolatAV, OzturkM, PolatAK, et al. Efficacy of ultrasound and shear wave elastography for the diagnosis of breast cancer-related lymphedema[J]. J Ultrasound Med, 2020,39(4):795-803. DOI: 10.1002/jum.15162.
    [49]
    ParkJY, JeonJY, ChaS. Ultrasonographic features of the skin and subcutis: correlations with the severity of breast cancer-related lymphedema[J]. Ultrasonography, 2024,43(4):284-293. DOI: 10.14366/usg.24059.
    [50]
    PirriC, PirriN, FerrarettoC, et al. Ultrasound imaging of the superficial and deep fasciae thickness of upper limbs in lymphedema patients versus healthy subjects[J]. Diagnostics (Basel), 2024,14(23):2697. DOI: 10.3390/diagnostics14232697.
    [51]
    KajitaH, SuzukiY, SakumaH, et al. Visualization of lymphatic vessels using photoacoustic imaging[J]. Keio J Med, 2021,70(4):82-92. DOI: 10.2302/kjm.2020-0010-OA.
    [52]
    HoelenCG, de MulFF, PongersR, et al. Three-dimensional photoacoustic imaging of blood vessels in tissue[J]. Opt Lett, 1998,23(8):648-650. DOI: 10.1364/ol.23.000648.
    [53]
    KajitaH, KishiK. High-resolution imaging of lymphatic vessels with photoacoustic lymphangiography[J]. Radiology, 2019,292(1):35. DOI: 10.1148/radiol.2019190241.
    [54]
    SuzukiY, KajitaH, WatanabeS, et al. Application of photoacoustic imaging for lymphedema treatment[J]. J Reconstr Microsurg, 2022,38(3):254-262. DOI: 10.1055/s-0041-1736518.
    [55]
    SuzukiY, KajitaH, UranoM, et al. Measurement of lymphatic vessel depth using photoacoustic imaging[J]. Lasers Surg Med, 2023,55(2):164-168. DOI: 10.1002/lsm.23629.
    [56]
    KajitaH, OhA, UranoM, et al. Photoacoustic lymphangiography[J]. J Surg Oncol, 2020,121(1):48-50. DOI: 10.1002/jso.25575.
    [57]
    OhA, KajitaH, MatobaE, et al. Photoacoustic lymphangiography before and after lymphaticovenular anastomosis[J]. Arch Plast Surg, 2021,48(3):323-328. DOI: 10.5999/aps.2020.02404.
    [58]
    WatanabeS, KajitaH, SuzukiY, et al. Photoacoustic lymphangiography is a possible alternative for lymphedema staging[J]. J Vasc Surg Venous Lymphat Disord, 2022,10(6):1318-1324.e2. DOI: 10.1016/j.jvsv.2022.07.012.
    [59]
    OhA, KajitaH, ImanishiN, et al. Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography[J]. Arch Plast Surg, 2022,49(1):99-107. DOI: 10.5999/aps.2021.01235.
    [60]
    FRY WJ, BARNARDJW, FRY EJ, et al. Ultrasonic lesions in the mammalian central nervous system[J]. Science, 1955,122(3168):517-518.
    [61]
    周吉平, 林宇仪, 朱敏菲, 等. 体外冲击波疗法联合综合消肿治疗对宫颈癌术后下肢淋巴水肿的临床疗效[J].中华烧伤与创面修复杂志,2025,41(6):543-551. DOI: 10.3760/cma.j.cn501225-20250205-00051.
    [62]
    LiuZ, LiJ, BianY, et al. Low-intensity pulsed ultrasound reduces lymphedema by regulating macrophage polarization and enhancing microcirculation[J]. Front Bioeng Biotechnol, 2023,11:1173169. DOI: 10.3389/fbioe.2023.1173169.
    [63]
    WangX, HanC, XiaJ, et al. Ultrasound-mediated piezoelectric microneedles regulating macrophage polarization and remodeling pathological microenvironment for lymphedema improvement[J]. ACS Nano, 2025,19(1):1447-1462. DOI: 10.1021/acsnano.4c14292.
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