{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:15:00Z","timestamp":1788257700069,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["G2023YFC3402600"],"award-info":[{"award-number":["G2023YFC3402600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC3402605"],"award-info":[{"award-number":["2023YFC3402605"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82471988"],"award-info":[{"award-number":["82471988"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To identify predictive ultrasonic factors and establish cutoff values for assessing sclerosis severity and selecting appropriate lymphatic vessels for lymphovenous anastomosis (LVA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 22 patients with extremity lymphedema undergoing LVA (53 lymphatic vessels). Sclerosis severity was determined preoperatively by ultrasonography and intraoperatively using a surgical microscope; the findings were stratified by NECST (normal, ectasis, contraction, and sclerosis type) classification. Demographic and ultrasonographic data, including lymphatic vessel inner and outer diameters (Id and Od, respectively), Id\/Od ratio, and wall thickness, were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Although NECST classifications for ultrasonographic and surgical observations exhibited discrepancies, ultrasound findings showed high overall accuracy (71.7%), with strong correlation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.652) and moderate agreement (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.554) with intraoperative results. For ultrasound\u2010based classification, Id and Id\/Od ratio of 0.43\u2009mm and 34.1% were the suggestive values for predicting ectasis type, with the area under the curve (AUC) values of 0.843 and 0.842, respectively. For surgical evaluation\u2010based classification, Id and Id\/Od ratio of 0.269\u2009mm and 41% were the suggestive values for predicting ectasis type, with both AUC values &gt;\u20090.8. These results were significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasonographic parameters could help identify ectasis type of lymphatic vessels in patients with extremity lymphedema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70342","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:30:22Z","timestamp":1788255022000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High\u2010Frequency Ultrasonography for Classifying Lymphatic Sclerosis Types in Patients With Lymphedema"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1506-3832","authenticated-orcid":false,"given":"Xiaoxue","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Ultrasonography Shenzhen Xinhua Hospital  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5789-6736","authenticated-orcid":false,"given":"Shufang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography Peking University Shenzhen Hospital  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ultrasonography Peking University Shenzhen Hospital  Shenzhen Guangdong 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