Department of Radiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Department of General Surgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
Balkan Med J. 2012 Sep;29(3):285-9. doi: 10.5152/balkanmedj.2012.010. Epub 2012 Sep 1.
To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes.
One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations postprocessing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (-LHR) of dynamic curves characterizing the axillary lymph nodes were calculated.
A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, -LHR were calculated as 14%, 1.04, 0.76 respectively.
Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients.
评估动力学特征在鉴别腋窝良恶性淋巴结中的作用。
本研究纳入 155 名女性患者。对磁共振成像（MRI）检查后进行后处理应用，从减影图像中获得动态曲线。在恶性病例中，将动态曲线的类型与组织病理学结果相关联；在无恶性证据的患者中，将其与最终临床结果相关联。计算了特征性腋窝淋巴结的动态曲线的灵敏度、特异性、阳性似然比（+LHR）和阴性似然比（-LHR）。
在 113 名患者中评估了 178 个大于 8 毫米的淋巴结。在 24 例中有 46 个淋巴结有恶性腋窝受累。在 89 名良性诊断的患者中有 132 个淋巴结被纳入研究。作为恶性指标的 3 型曲线的灵敏度计算为 89%。然而，特异性、+LHR、-LHR 分别计算为 14%、1.04、0.76。
由于良性和恶性腋窝淋巴结的动力学分析，快速增强和洗脱（3 型）不能像乳腺病变那样作为鉴别器。MRI 取决于腋窝淋巴结的动力学特征，不足以用于乳腺癌患者的临床管理。
