Melanoma - Soft Tissues - Head & Neck - Skin Cancers, INT Pascale.
Department of Radiology, INT Pascale.
Ultraschall Med. 2012 Dec;33(7):E179-E185. doi: 10.1055/s-0032-1312827. Epub 2012 Aug 24.
The objective of our study was to define the diagnostic accuracy of high-resolution ultrasound (US) in detecting nodal involvement before sentinel lymph node biopsy (SLNB) in patients with cutaneous melanoma, to define the sonographic criteria used to assess nodal metastases, and to establish if high-resolution US can directly select patients to radical lymphadenectomy, sparing selective lymphadenectomy.
623 patients underwent high-resolution US of the regional lymph nodes, 24 hours prior being submitted to the sentinel lymph node biopsy procedure. The US findings were compared with histological findings.
In 14.7 % out of 122 excised lymph nodes, high-resolution US showed sonographic features consistent with malignant involvement before the surgical step. US scan sensitivity and specificity were 15 and 100 %, respectively, since positive and negative predictive values were 100 and 87 % respectively.
US is an effective modality in the presurgical detection of subclinical deposits within sentinel lymph nodes. However, preoperative staging work-up with high-resolution US cannot substitute the SLNB, mainly because of low sensitivity due to missing many micrometastases.
本研究旨在确定在接受前哨淋巴结活检 (SLNB) 之前，高分辨率超声 (US) 在检测皮肤黑色素瘤患者淋巴结受累方面的诊断准确性，确定用于评估淋巴结转移的超声标准，并确定高分辨率 US 是否可以直接选择接受根治性淋巴结切除术的患者，而无需选择性淋巴结切除术。
623 例患者在接受前哨淋巴结活检术前 24 小时接受了区域淋巴结的高分辨率 US 检查。将 US 结果与组织学结果进行比较。
在 122 个切除的淋巴结中，有 14.7%在手术前的 US 检查中显示出与恶性浸润一致的超声特征。US 扫描的灵敏度和特异性分别为 15%和 100%，因为阳性和阴性预测值分别为 100%和 87%。
US 是术前检测前哨淋巴结内亚临床转移的有效方法。然而，术前高分辨率 US 分期检查不能替代 SLNB，主要是因为灵敏度低，会遗漏许多微转移灶。
