Stiglich F, Barbonetti C, Di Lorenzo E, Gherardi G, Maspero S, Bottinelli O, Bonomo F, Bottinelli G, Campani R
Servizio di Medicina Nucleare e Radioterapia, Ospedale Civile, Sondrio.
Radiol Med. 1991 Jun;81(6):838-43.
The demonstration of metastatic involvement of neck nodes is a crucial step in the staging of patients with head and neck tumors. Diagnostic accuracy, sensitivity, and specificity of US in the detection of lymph node metastases were evaluated in 48 patients with this type of malignancy. The patients subsequently underwent surgical node dissection. Comparison of US, clinical and histological data demonstrated US to have 93.7% diagnostic accuracy, 100% sensitivity, and 84% specificity--the corresponding clinical values being 81%, 79%, and 84%, respectively. Among several US parameters, a substantial role in differentiating metastatic from tumor-free lymph nodes was played by the evaluation of roundness index (RI), and by the demonstration of an intranodal hyperechoic stria: RI value was always higher than 2 in tumor-free nodes and the hyperechoic stria was always absent in metastatic nodes. US approach never failed to demonstrate metastatic nodes while clinics missed them in 6 patients. Thus, US appears the most valuable diagnostic tool for staging head and neck tumors; its diagnostic accuracy can be increased by the combination with US-guided aspiration biopsy.
颈部淋巴结转移情况的显示是头颈肿瘤患者分期的关键步骤。对48例此类恶性肿瘤患者评估了超声检测淋巴结转移的诊断准确性、敏感性和特异性。这些患者随后接受了手术淋巴结清扫。超声、临床和组织学数据的比较显示，超声的诊断准确性为93.7%，敏感性为100%，特异性为84%，而相应的临床值分别为81%、79%和84%。在几个超声参数中，圆形度指数（RI）的评估以及淋巴结内高回声条纹的显示在区分转移淋巴结和无肿瘤淋巴结方面发挥了重要作用：无肿瘤淋巴结的RI值总是高于2，而转移淋巴结中总是不存在高回声条纹。超声检查从未漏诊转移淋巴结，而临床检查漏诊了6例患者。因此，超声似乎是头颈肿瘤分期最有价值的诊断工具；通过与超声引导下穿刺活检相结合可提高其诊断准确性。
