Quantitative volumetrische Analyse der unteren Extremität: Validierung gegenüber etablierter Maßbandmessung und Wasserverdrängung

Zusammenfassung

Hintergrund Zur Diagnostik und Therapieevaluation des Lip- und Lymphödems werden im klinischen Alltag weiterhin Maßbandmessungen eingesetzt. Hierbei werden ausgehend von standardisierten Umfangsmessungen im Bereich der betroffenen Extremitäten deren Volumina errechnet. Andere Verfahren wie Wasserverdrängung werden nicht regelhaft eingesetzt.

Ziel dieser Studie war die Erprobung eines 3D Scanners als alternatives und reproduzierbares Tool zur objektiven Erfassung der Volumina der unteren Extremität.

Patienten, Material und Methoden Wir führten an 20 Probanden 3D Scans der unteren Extremitäten mit einem handelsüblichen 3D Scanner, dem Artec Eva^® durch, und errechneten das Volumen mit der dazugehörigen Software. Das Volumen der Extremitäten wurde zudem gemäß standardisierter Verfahren durch die Umfangsmethode (Konusmethode und Scheibenmethode) sowie per Wasserverdrängungstechnik bestimmt. Die Ergebnisse sowie Durchführungsdauer der drei Messmethoden wurde dokumentiert und statistisch ausgewertet.

Ergebnisse Mittels 3D Volumetrie zeigten sich keine signifikanten Abweichungen zur Wasserverdrängung (p > 0,05). Die Konusmethode überschätzte signifikant das in der Wasserverdrängung und 3D Volumetrie gemessene Volumen deutlich. Die Scheibenmethode zeigte keine statistisch signifikanten Abweichungen, jedoch klinisch relevant hohe Abweichungen mit einer ausgeprägten Varianz im 95 % Konfidenzintervall. Alle Verfahren zeigten hohe positive Korrelationen zueinander. Die Wasserverdrängung zeigte sich mit dem größten zeitlichen Aufwand verbunden.

Schlussfolgerung Unserer Ergebnisse nach Untersuchung von 40 unteren Extremitäten zeigen, dass durch 3D Scans und Software-basierte volumetrische Berechnung in kurzer Zeit objektive und reproduzierbare Ergebnisse erzielt werden können. Die Abweichung gegenüber dem Goldstandard

Abstract

Background Tape measures continue to be used for the diagnosis and evaluation of lipoedema and lymphoedema in the clinical routine. Extremity volumes are calculated based on standardised circumferential measurements. Other volume measurements such as water displacement are not applied on a regular basis. This study aimed to evaluate a 3D scanner as an alternative and reproducible tool to objectively measure the volumes of the lower extremity.

Patients, materials and method We used a commercially available 3D scanner, the Artec Eva^®, to perform 3D scans of the lower extremities on 20 subjects and calculated the volume using the appropriate software. In addition, limb volume was determined with standardised methods using the circumferential method (cone method and disc method) and the water displacement technique. The results and the time taken to perform the three measurement methods were documented and statistically evaluated.

Results There were no significant deviations between the results from 3D volumetry and water displacement (p > 0.05). The cone method significantly overestimated the volume measured by water displacement and 3D volumetry. The disc method revealed no statistically significant differences, but clinically relevant differences with a high variance in the 95 % confidence interval. All methods demonstrated high positive correlations with each other. Water displacement was the most timeconsuming method.

Conclusion Our findings obtained from the examination of 40 lower extremities show that 3D scans and software-based volumetric calculations can achieve objective and reproducible measurements in a relatively short time. The deviation from the gold-standard method of water displacement is small. Compared with the cone and disc method, however, we observed clinically relevant deviations with a high variance. We therefore recommend the 3D scan procedure for the objective documentation of conservative and surgical treatments for lipoedema or lymphoedema and have incorporated it into our clinical routine.

Schlüsselwörter

Ästhetisch-Plastische Chirurgie - 3D Scan - Volumetrie - Extremitäten - Lipödem - Liposuktion

Key words

Liposuction - Volumetry Extremities - lipoedema

Fußnote

^* equally contributed to paper (geteilte Letztautorenschaft)

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