Ultrasonographic findings addition for the differentation of malign and benign lenfadenopaty
Journal Name:
- Süleyman Demirel Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi
Keywords (Original Language):
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Abstract (2. Language):
Aim: The aim of this study was to evaluate efficacy of
B mod US and colour doppler US on the differential
diagnosis of benign and malign cervical lymph nodes
by comparing fine-needle aspiration biopsy results, and
display the fact that whether colour doppler US had a
positive effect upon the diagnosis value of B mod US
analysis when they were combined.
Material and Method: Fourty nine patients were included
in this study. B mod US and colour doppler US were
practiced on all the cases. The analysis were done with
SDU2200 (Shimadzu, Tokyo, Japan) coloured doppler
device by using 7.5 mhz lineer transduser probe. The
biggest cervical lymph node was included to the study. The
efficiency of B mod US and colour doppler US facts was
rated in the values of sensibility, specificity, positive and
negative provisions by taking based on the histopathological
results.
Findings: In the evaluation of 49 cases, the lymph nodes
diagnosed as malign by means of B mod US or colour
doppler US or with both of them were considered to be
malign; the lymph nodes were assumed as benign if they
were diagnosed as benign by using the both methods. As a
result, 21 lymph nodes were considered to be malign and
28 lymph nodes were benign.
In the fact that when the 49 patients that were taken up into
the study, were evaluated with one of the B mod US and
colour doppler US or with both of them, the lymph nods
that take malign diagnosis are thought as malign, according
to both investigations, when lymph nods that take benign
diagnosis are assumed as benign, they are thought as 21
lymph nods malign and 28 lymph nods benign.
Conclusion: When lymph nodes were assumed as malign
with the existence of at least two of the malignancy criteria
defined for B mod US (rounded shape, longitudinal/
transverse diameter percentage, loss of hilar echogenicity,
contour lobulation and necrosis of lymph nodes), the rates of sensitivity and specificity were clearly high. In
addition to these findings, vascular pattern and spectral
wave analysis made in the benign and malign lymph
nodes increased the rates of sensitivity and specificity and
decreased the number of false negative facts noticeably.
When rounded shape define for B mod US with malignancy,
longitunidal/transvers diameter percentage, loss of hilar
echogenicity, contour lobulation and lymph nods whose
necrosis existence criterias are positive as at least two of
those, are assumed as malign, the rates of sensitivite and
spesifty are clearly high. In addition to these findings, it is
thought that vasculer patern and spectral wave analysis that is
looked up into the benign and malign lymph nods, redoubles
the rates of sensitivity and specifity and it is also thought that
it decreases the number of false negative facts noticeably.
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Abstract (Original Language):
Amaç: Çalışmanın amacı benign ve malign servikal lenf
nodlarının ayırıcı tanısında B mod US ve renkli doppler US
bulgularının etkinliğini İİAB (İnce iğne aspirasyon biyopsisi)
sonuçları ile karşılaştırarak değerlendirmek, kombine
edildiklerinde renkli doppler US’nin B mod US incelemenin
tanı değerine katkısı olup olmadığı ortaya koymaktır.
Gereç Yöntem: Çalışmaya 49 hasta dahil edildi. Tüm
olgulara B-mod US ve renkli doppler US incelemeleri
uygulandı. İnceleme SDU2200, Shimadzu, Tokyo, Japan
renkli doppler cihazıyla 7.5 MHz’lik lineer transdüser
prob kullanılarak yapıldı. Çalışmaya en büyük servikal
lenf nodu dahil edildi. Histopatolojik sonuçlar temel
alınarak B mod US ve renkli doppler US bulgularının
etkinliği duyarlılık, özgüllük, pozitif ve negatif öngörü
değerleri şeklinde hesaplandı.
Bulgular: Çalışmaya dahil edilen 49 olgunun B mod US
ve renkli doppler US’den herhangi birisi ile ya da her
ikisi birlikte değerlendirilmesinde; malign tanı almış lenf
nodları malign, her iki incelemeye göre benign tanı alan
lenf nodları benign kabul edildiğinde 21 lenf nodu malign,
28 lenf nodu benign olarak düşünülmüştür.
Sonuç: B mod US ile malignite için tanımlanan
yuvarlak şekil, longitudinal/transvers çap oranı, hiler
ekojenite kaybı, kontur lobülasyonu ve nekroz varlığı
kriterlerinden en az ikisi pozitif olan lenf nodları malign
kabul edildiğinde, sensitivite ve spesifite oranları belirgin
yüksek olup, bu bulgulara ek olarak benign ve malign
lenf nodlarında bakılan vasküler patern ve spektral dalga
analizinin sensitivite ve spesifite oranlarını arttırdığı ve
yalancı negatif olgu sayısını belirgin şekilde azalttığı
düşünülmüştür.
Anahtar kelimeler: Servikal lenf nodu, Ultrasonografi,
Renkli Dopler Ultrasonograf
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