Use of non-contrast MR in diagnosing secondary lymphedema of the upper extremities (reply to a letter to the Editor)

Abstract

We appreciate the opportunity to reply to the letter regarding the use of US as alternative to MRI as a diagnostic method for lymphedema diagnosis and tracking. The authors point out several advantages of US over MRI in the assessment of dermal thickening and subcutaneous edema: lower expense, easier access, and the virtual lack of contraindications to US. We completely agree that US is an indispensable tool for the evaluation of upper and lower extremity lymphedema. In addition to conventional US exams, ultra-high-frequency ultrasound (UHFUS), operating up to 70 MHz, has demonstrated a role in visualization of lymphatic channels. 1. Hayashi A. Giacalone G. Yamamoto T. Belva F. Visconti G. Hayashi N. Handa M. Yoshimatsu H. Salgarello M. Ultra high-frequency ultrasonographic imaging with 70 MHz scanner for visualization of the lymphatic vessels. Plast Reconstr Surg Glob Open. 2019; 7e2086https://doi.org/10.1097/GOX.0000000000002086 Google Scholar At our lymphedema clinic, we regularly use UHFUS to select sites for lympho-venous bypass.