유방암 수술 후 환자의 환측 상지에서 컴퓨터로 제어되는 초음파를 이용한 조직 탄성도 분석
The analysis of tissue elasticity using computer-controlled ultrasonography in the affected upper limb of patients after breast cancer surgery
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초록
본 연구에서는 컴퓨터로 제어되는 초음파를 이용하여 피하 조직의 탄성도를 도출할 수 있는 방법을개발하였다. 림프 부종은 유방암 수술에서 흔한 합병증으로 유방암 생존자에 있어 삶의 질을 저하시키는주요 원인으로 알려져 있다. 그러나 아직 부종 조직의 성상을 정량적으로 분석할 수 있는 방법은 정립되어있지 않다. 유방암 수술 이후 한 쪽 상지에 부종으로 인한 불편감을 호소하는 환자를 대상으로 총30례의 부종 조직과 그에 상응하는 정상 조직에서의 초음파 분석을 수행하였고, 건측과 환측 간 탄성도의차이를 도출하였다. 그에 따라 차이가 음수인 더 딱딱한 그룹과(n=13) 양수인 더 부드러운 그룹으로(n=17) 분류하였다. 컴퓨터 제어 초음파 검사와 실시간 압력 센서를 이용한 피하 조직 탄력성 평가는 유방암수술 후 발생한 림프 부종 환자에서 조직의 성상을 분석할 수 있는 유용한 도구가 될 것이다.
Abstract
In this paper, we propse a quantitative research by investigating the subcutaneous tissue elasticity by using ultrasonography in lymphedema patients after breast cancer surgery. Lymphedema patients who took breast cancer operation were included. Thickness of subcutaneous tissue was assessed at two spots; 10cm below elbow (forearm) and 10cm above elbow (upper arm), not only in affected side but also in sound side. By using probe attached to real-time pressure sensor, stress-strain curves were obtained. We defined tissue elasticity as slope of that curve at range of 7.5~15% of strain to avoid toe region. By comparing the elasticity of normal side and that of affected side, lymphedema tissues were classified into ‘softer’ and ‘harder’ tissues. Overall 30 cases of lymphedema tissues and 30 cases of sound tissues were checked. The difference of the elasticity between normal and affected side ranged from -3.98 N/m2 to 1.40 N/m2. The lymphedema tissues were classified into 17 softer tissues and 13 harder tissues. No demographic and clinical values, including clinical stage of lymphedema, showed statistically meaningful differences between two groups. Evaluation of subcutaneous tissue elasticity with ultrasonography and real-time pressure sensor could be one of the useful tools for investigation of lymphedema tissue characteristics.
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