Correlation Between the Severity of Subcutaneous Echo-Free Space and the Amount of Extracellular Fluid Determined by Bioelectrical Impedance Analysis of Leg Edema

Lymphat Res Biol. 2017 Jun;15(2):172-176. doi: 10.1089/lrb.2016.0041.

Abstract

Background: Both subcutaneous echo-free space (SEFS) observed by ultrasonography and the ratio of intracellular fluid resistance to extracellular fluid resistance (Ri/Re) calculated from bioelectrical impedance analysis (BIA) represent extracellular edema status in the extremities. We tried to correlate these parameters.

Methods and results: In 70 legs with venous edema (VE) and 68 legs with lymphedema (LE), subcutaneous tissue ultrasonography to determine SEFS severity (range, 0-2) and BIA to calculate Ri/Re were performed. In the calf, SEFS severity showed good linear correlation with Ri/Re, particularly in the lower lateral calf where the mean Ri/Re for LE (SEFS grade 0: 3.2 ± 0.8; SEFS grade 1: 4.0 ± 0.9; SEFS grade 2: 6.3 ± 3.6) and VE (SEFS grade 0: 3.6 ± 0.6; SEFS grade 1: 4.4 ± 1.6; SEFS grade 2: 5.3 ± 2.0) was similar. In the thigh, a mild correlation was confirmed only in LE.

Conclusions: It may be concluded that SEFS in the lower calf area well represents the local fluid status regardless of the type of edema, but not so in the thigh.

Keywords: bioelectrical impedance analysis; chronic venous insufficiency; lymphedema; ultrasonography.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Edema / diagnosis*
  • Edema / etiology
  • Edema / therapy*
  • Electric Impedance*
  • Extracellular Fluid*
  • Female
  • Humans
  • Leg / pathology*
  • Male
  • Middle Aged
  • Severity of Illness Index