Mayrovitz HN
Lymphatic research and biology. Date of publication 2019 Jan 30;volume ():.
1. Lymphat Res Biol. 2019 Jan 30. doi: 10.1089/lrb.2018.0039. [Epub ahead of print]
Assessing Lower Extremity Lymphedema Using Upper and Lower Extremity Tissue
Dielectric Constant Ratios: Method and Normal Reference Values.
Mayrovitz HN(1).
Author information:
(1)Department of Physiology, College of Medical Sciences, Nova Southeastern
University, Fort Lauderdale, Florida.
BACKGROUND: Lower extremity swelling accompanies many conditions, including
gynecological surgery and chronic venous dysfunction. Some clinical and
quantitative assessment methods exist, but other ways to rapidly assess early
lymphedema and track changes are needed. Our goal was to use lower to upper
extremity intraside tissue dielectric constant (TDC) ratios with the specific aim
of providing normal reference values potentially useful as a comparison measure
against which persons at risk for lower extremity lymphedema might be evaluated.
METHODS AND RESULTS: TDC ratios (calf/forearm, foot/forearm) were measured in 44
young (25.1 ± 2.2 years) and 60 mature (60.1 ± 11.5 years) volunteers equally
divided by gender. Foot/forearm and calf/forearm ratios did not differ between
genders. For mature, values measured on dominant sides were 1.050 ± 0.151 and
1.013 ± 0.162, respectively. Lymphedema threshold ratios, calculated as the mean
ratio plus twice their respective standard deviations, were for calf/forearm and
foot/forearm 1.352 and 1.337, respectively. As an initial test of the thresholds,
they were compared to TDC ratios determined in six patients with lower extremity
edema due to congestive heart failure.
CONCLUSION: Based on these findings, it is proposed that a calf/forearm TDC ratio
that exceeds 1.35 is suggestive of lower extremity lymphedema and that the
calf/forearm ratio could be used to track temporal changes and therapy-related
improvements. The test of these conclusions requires future research in which
these intraside TDC ratios and thresholds are evaluated in patients with lower
extremity lymphedema and venous-related edema. This work provides the reference
values for such comparisons to be systematically done.
DOI: 10.1089/lrb.2018.0039
PMID: 30698489
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