Investigation Potential of Laser Doppler Flowmetry for Patients with Secondary Lymphedema of Lower Extremities Examination
[1]
Petr Vasilev, The Department of Physiology, the Faculty of Medicine, Saint-Petersburg State University, Saint-Petersburg, Russia.
[2]
Nikolay Yerofeyev, The Department of Physiology, the Faculty of Medicine, Saint-Petersburg State University, Saint-Petersburg, Russia.
Nowadays diseases of the lymphatic vessels are widely spread pathologies. So the development of non-invasive diagnostic methods is relevant. It is strictly interesting to investigate potential possibilities of laser Doppler flowmetry (LDF) in the appraisal of pathological changes of lymphodynamics. This method is widely used for investigation of blood vessels diseases, not for lymphatic ones. The aim of our research was to analyze changes of the accessory indexes of the LDF-gramme, registered from patients with secondary lymphedema of lower extremities. The investigation group included 10 patients, 27-65 years old, both sexes, with a clinically-manifested secondary lymphedema of lower extremities. The control group included 30 healthy volunteers, same age. Parameters of microcirculation were assessed through the system Biopac LDF 100C (Biopac instruments, USA). The investigation protocol included a 2-minutes long LDF-gramme recording on each lower extremity. In the course of output LDF signal processing amplitude–frequency spectra were constructed. For describing characteristic spectrum changes we used special indexes: low frequency flaxmotions investment and flaxmotions index. Patterns of amplitude-frequency spectra, registered from the investigation group differed from the control group. In the investigation group a significant decreasing of low frequency flaxmotions investment (p<0.05) were registered. Because of that, it was traced a trend to decreasing of flaxmotions index. According to the general conception of LDF-spectra areas, these changes are evidence of decreasing of the investment of local active mechanisms for modulation of the liquid stream in the microvasculature. We think that lymphatic microcirculation can also take part in forming of the output LDF signal because of the slowdown of the lymph flow and changing of the chemical structure of the lymph. This process changes the optical characteristics of the lymph and makes it recognizable for LDF. This phenomenon can be interpreted as a consequence of vessels dysfunction. Decreasing of the investment of local active mechanisms, probably, is caused by depression of lymphangion motility. These results are adjusted to relevant information about the pathogenesis of secondary lymphedema. So, it is possible to say that LDF has a diagnostic potential for patients with secondary lymphedema of lower extremities at the stage of initial structural and functional changes. A perspective aim for next study is inventing new algorithms of LDF-signal processing for more-detailed registration of non-periodic components of lymphodynamics. These results give a possibility for future development of LDF using in diagnostics of lymph vessels pathologies and monitoring of the effectiveness of the treatment.
Laser Doppler Flowmetry, Secondary Lymphedema, Noninvasive Diagnostic Methods, Microvasculature, Lymphodynamics
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