{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T19:42:42Z","timestamp":1789933362963,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T00:00:00Z","timestamp":1705190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Indocyanine green (ICG) lymphography is the reference standard for evaluating lymphedema stage and identifying lymphatic vessels. However, the penetration depth was limited to 1\u20132\u2009cm from the skin surface. This prospective study compares clinical outcomes following lymphaticovenous anastomoses (LVA) in patients with upper and lower limb lymphedema using contrast\u2010enhanced ultrasonography (CEUS) with ICG as a preoperative imaging modality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Under general anesthesia, Sonazoid\u00ae was injected subcutaneously to visualize functional lymphatic channels via CEUS. We analyzed the changes in limb circumference and inter\u2010limb ratio (ILR) using bioimpedance to measure electrical resistance between the CEUS plus ICG group and the ICG\u2010only group to see the effect of CEUS\u2010assisted LVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No significant demographic differences existed between the two groups (CEUS plus ICG group vs. ICG\u2010only group). The ILR decrease of the <jats:italic>Z<\/jats:italic><jats:sub>1<\/jats:sub> value measured using bioimpedance was statistically significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.042 for the upper limb, <jats:italic>p<\/jats:italic>\u2009=\u20090.002 for the lower limb)\u2010<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CEUS allowed us to identify deep\u2010lying, functional, and large lymphatic channels. In conclusion, the combination of CEUS and ICG for identifying lymphatic channels has the potential to lead to a more functional lymphovenous anastomosis<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27576","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T05:08:19Z","timestamp":1705295299000},"page":"965-974","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Contrast\u2010enhanced ultrasonography as an adjunctive method to ICG lymphography for functional lymphaticovenous anastomosis"],"prefix":"10.1002","volume":"129","author":[{"given":"Young Woong","family":"Mo","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Yonsei University College of Medicine, Severance Hospital Seoul South Korea"},{"name":"Institute for Human Tissue Restoration Yonsei University College of Medicine Seoul South 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