Fig 1.
The diffuse pattern, which represents severe abnormality, was not observed in this study. (a) Linear pattern, indicating normal lymphatic flow. (b) Splash pattern, an early abnormal finding resembling brush strokes. (c) Stardust pattern, indicating moderate abnormality.
Fig 2.
Lymphatic ultrasound findings.
Yellow circles indicate the lymphatic vessels. (a) Normal lymphatic vessel without dilation, appearing as a high-echo structure resembling an equal sign. (b) Dilated lymphatic vessel due to lymphatic stasis.
Fig 3.
Temporal changes in concordance and discordance between indocyanine green (ICG) lymphography and lymphatic ultrasound across postoperative timepoints.
The stacked bars represent the proportions of limb-timepoints classified into four categories according to the agreement between the two imaging modalities: (1) Concordant abnormal findings — abnormal ICG findings with lymphatic dilation on ultrasound; (2) Discordant findings indicating functional abnormality without structural change — abnormal ICG findings without lymphatic dilation on ultrasound; (3) Discordant findings indicating structural change without functional abnormality — normal ICG findings with lymphatic dilation on ultrasound; and (4) Concordant normal findings — normal findings on both ICG lymphography and lymphatic ultrasound. Overall, the figure shows a temporal shift from predominantly discordant findings in the early postoperative phase to an increased proportion of concordant abnormal findings at 9 months.]US: ultrasound.
Fig 4.
Association between indocyanine green (ICG) lymphography patterns and lymphatic dilation on ultrasound over time.
This figure shows the proportion of limbs with lymphatic vessel dilation (LVD) according to ICG lymphography patterns (normal, splash, and stardust) at each postoperative time point. Splash patterns were frequently observed without accompanying lymphatic dilation in the early postoperative phase, whereas stardust patterns were more consistently associated with structural changes, particularly at 9 months postoperatively, highlighting the temporal progression from functional to structural abnormalities. US: ultrasound, DB: dermal backflow.
Fig 5.
Temporal changes in skin thickness after gynecologic cancer surgery.
Skin thickness significantly increased at 9 months in the medial and lateral lower legs (p = 0.035 and p = 0.020). Thickness increased steadily in the stardust group, peaked transiently in the Splash group and Stardust group, and remained stable in the no abnormality group (-). LT; lateral thigh, MT; medial thigh, LC; lateral calf, MC; medial calf.