Departments of Radiology.
General Surgery.
Ultrasound Q. 2023 Jun 1;39(2):74-80. doi: 10.1097/RUQ.0000000000000617.
The aim was to evaluate the effectiveness of superb microvascular imaging (SMI) in axillary lymph nodes (LNs).Benign and malignant LNs diagnosed via histopathological examination constituted the study subgroups. In addition to grayscale findings for morphological evaluation, vascular patterns and appearance of internal vessels were analyzed by both power Doppler ultrasound (PDUS) and SMI. The number of vascular branches was counted, and a vascularity index (VI) was calculated by SMI.Fifty-two LNs with suspicious findings in terms of metastasis (33 malignant and 19 benign) were evaluated. Diagnostic accuracy according to vascular patterns was 82% for PDUS and 92% for SMI. In the presence of asymmetric cortical thickening, there was a significant difference between benign and malignant LNs in the number of vascular branches of both thin and thick cortical sides ( P < 0.01). Mean VI was significantly higher in the malignant group ( P < 0.05). In differentiating malignancy, when a cutoff VI value was set to 9%, sensitivity was 69.7%, and specificity was 63.2%.Evaluating the vascularity of axillary LNs by SMI is a useful tool in determining the potential of axillary metastasis, especially in the absence of typical sonographic findings. Superb microvascular imaging can beneficially be used to select the most suspicious LN and suspicious area of the LN to sample.
目的是评估超级微血管成像（SMI）在腋窝淋巴结（LNs）中的有效性。通过组织病理学检查诊断为良性和恶性的 LNs 构成了研究亚组。除了灰阶发现进行形态评估外，还通过功率多普勒超声（PDUS）和 SMI 分析血管模式和内部血管的外观。计数血管分支的数量，并通过 SMI 计算血管指数（VI）。评估了 52 个有转移可疑迹象的 LNs（33 个恶性和 19 个良性）。根据血管模式的诊断准确性，PDUS 为 82%，SMI 为 92%。在存在皮质不对称性增厚的情况下，良性和恶性 LNs 的薄皮质侧和厚皮质侧的血管分支数量存在显著差异（P<0.01）。恶性组的平均 VI 显著较高（P<0.05）。在鉴别恶性肿瘤时，当设定 VI 值截点为 9%时，敏感性为 69.7%，特异性为 63.2%。通过 SMI 评估腋窝 LNs 的血管生成是确定腋窝转移潜力的有用工具，特别是在缺乏典型超声发现的情况下。SMI 可以有益地用于选择最可疑的 LN 和 LN 的可疑区域进行采样。
