Hata Y, Ogawa Y, Nishioka A, Inomata T, Yoshida S, Toki T
Department of Radiology, Kochi Medical School.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Dec;56(14):1027-31.
A retrospective study was performed to determine whether thin section CT scanning in the prone position of the breast and the axilla yielded useful information regarding the status of axillary lymph nodes in patients with breast cancer. Thirty-six patients with breast carcinomas were scanned preoperatively from the supraclavicular regions to the breast in the prone position with 5 mm sections. Axillary lymph nodes measuring > or = 5 mm on the short axis were considered abnormal. Correlation with axillary dissection was obtained in all patients, giving a positive predictive value for axillary metastases of 83.3%, with 88.2% sensitivity, 84.2% specificity, and 88.8% negative predictive value. We concluded that thin section CT scan in the prone position was an accurate predictor of axillary lymph node involvement. We made a phantom with lymph node swelling to evaluate whether CT scanning with 5 mm sections was necessary for detecting 5 mm swollen lymph nodes. We scanned the phantom with 5 mm and 10 mm sections. Twelve radiologists counted the swollen lymph nodes on 5 mm section images and 10 mm section images of the phantom. The average number of miscounts was 1.1 (miscount rate 6.8%) on 5 mm section and 2.8 (15%) on 10 mm sections. We concluded that 5 mm section CT scanning is superior for detecting 5 mm lymph nodes.
进行了一项回顾性研究，以确定乳腺癌患者在俯卧位时对乳房和腋窝进行薄层CT扫描是否能提供有关腋窝淋巴结状况的有用信息。36例乳腺癌患者术前在俯卧位从锁骨上区域至乳房进行扫描，层厚5mm。短轴直径≥5mm的腋窝淋巴结被视为异常。所有患者均与腋窝淋巴结清扫结果进行了相关性分析，腋窝转移的阳性预测值为83.3%，敏感性为88.2%，特异性为84.2%，阴性预测值为88.8%。我们得出结论，俯卧位薄层CT扫描是腋窝淋巴结受累的准确预测指标。我们制作了一个伴有淋巴结肿大的模型，以评估5mm层厚的CT扫描对于检测5mm肿大淋巴结是否必要。我们分别用5mm和10mm层厚对模型进行扫描。12名放射科医生对模型的5mm层厚图像和10mm层厚图像上的肿大淋巴结进行计数。5mm层厚图像上的平均漏计数为1.1个（漏计率6.8%），10mm层厚图像上为2.8个（15%）。我们得出结论，5mm层厚的CT扫描在检测5mm淋巴结方面更具优势。
