Nazarian L N, Alexander A A, Rawool N M, Kurtz A B, Maguire H C, Mastrangelo M J
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5244, USA.
Radiology. 1996 Apr;199(1):273-7. doi: 10.1148/radiology.199.1.8633159.
To evaluate the impact of superficial ultrasonography (US) on clinical management of melanoma.
Superficial US in areas at high risk for local recurrence or nodal metastases was performed in 33 patients with cutaneous melanoma. Impact categories were assigned to each US study (n = 55): category 3, US added information that altered clinical management; category 2, US added information that did not change management; category 1, no added information and management unchanged; category 0, not helpful or was misleading.
Twenty-two US studies (40%) were category 3: detection of nonpalpable metastases altered surgical therapy (n = 2), demonstration of pharmacodynamic response to chemotherapy (n = 5), and determination of benignancy or malignancy (n = 15). Nine (16%) were category 2: identification of nonpalpable metastases did not alter management. Twenty-two (40%) were category 1: supported clinical impression of no metastases (n = 18) or helped confirm cutaneous, subcutaneous, or nodal metastases (n = 4). Two (4%) were category 0: missed proved metastases.
Superficial US affected management of melanoma by allowing detection and characterization of masses, guidance of biopsy, and assessment of pharmacodynamic response.
评估浅表超声（US）对黑色素瘤临床管理的影响。
对33例皮肤黑色素瘤患者在局部复发或区域淋巴结转移高危区域进行浅表超声检查。为每项超声检查（n = 55）指定影响类别：3类，超声提供的信息改变了临床管理；2类，超声提供的信息未改变管理；1类，未提供额外信息且管理未改变；0类，无帮助或有误导性。
22项超声检查（40%）为3类：发现不可触及的转移灶改变了手术治疗（n = 2），显示对化疗的药效学反应（n = 5），以及确定良性或恶性（n = 15）。9项（16%）为2类：发现不可触及的转移灶未改变管理。22项（40%）为1类：支持无转移的临床印象（n = 18）或有助于确认皮肤、皮下或区域淋巴结转移（n = 4）。2项（4%）为0类：漏诊已证实的转移灶。
浅表超声通过发现和鉴别肿块、引导活检以及评估药效学反应影响黑色素瘤的管理。
