健康な若年女性における昼下がりの生理的下肢浮腫のソノグラフィー検出．

Sonographic detection of physiological lower leg edema in the late afternoon in healthy young women.

• Shohei Shibasaki
• Tomonori Kishino
• Tomomi Yokoyama
• Sakura Sunahara
• Keiichiro Harashima
• Satoshi Nakajima
• Hiroaki Ohnishi
• Takashi Watanabe

抄録

下腿浮腫は日中活動後の夕方に生理的に発生する。近年，浮腫に関連した様々な超音波所見が報告されているが，この生理的下肢浮腫を画像検査で定量的に評価した例はない．本研究では，ソノグラフィーによる生理的下肢浮腫の検出が可能かどうかを検討し，午前中と午後の測定値を比較した．また、下肢浮腫の原因と考えられる下肢静脈の直径も測定した。被験者は健康な若い女性55人（平均年齢21±1歳）であった。その結果、乳頭真皮厚、皮下脂肪組織厚、エコージェニック（画像解析ソフトを用いたグレースケールでの推定値）などの浮腫関連所見は、午前中に比べて午後後半に増加した（1.4 [1.7-1.7]）。4 [1.1-1.7] mm vs. 1.4 [1.1-1.8] mm、p＜0.01、7.3 [6.0-8.1] mm vs. 7.3 [6.1-8.3] mm、p＜0.05、37.3 [31.5-39.4] vs. 39.8 [35.7-44.1]、p＜0.01）。)大伏在静脈、小伏在静脈、足背静脈などの下肢静脈の直径は、いずれも午後遅くに向かって減少していた（それぞれp<0.01）。健康な若年女性の日中活動後の生理的下肢浮腫に伴う身体変化をソノグラフィーで定量的かつ正確に検出した。

Lower leg edema occurs physiologically in the evening after daytime activity. Various edema-related sonographic findings have recently been reported, but this physiological edema has not been evaluated quantitatively using imaging examinations. The present study investigated whether sonography could detect physiological lower leg edema, comparing measured values between the morning and late afternoon. Diameters of leg veins were also measured as a possible source of leg edema. Subjects comprised 55 healthy young women (mean age, 21±1 years). Edema-related findings such as papillary dermis thickness, subcutaneous adipose tissue thickness, and echogenicity (as estimated in gray-scale using image analysis software) increased in the late afternoon when compared with those in the morning (1.4 [1.1-1.7] mm vs. 1.4 [1.1-1.8] mm, p<0.01; 7.3 [6.0-8.1] mm vs. 7.3 [6.1-8.3] mm, p<0.05; and 37.3 [31.5-39.4] vs. 39.8 [35.7-44.1], p<0.01, respectively). Diameters of leg veins such as the great saphenous vein, small saphenous vein, and dorsal vein of the foot were all reduced toward late afternoon (p<0.01 each). Sonography quantitatively and precisely detected physical changes associated with physiological lower leg edema after daytime activity in healthy young women.

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