Duda S H, Huppert P E, Schott U, Brambs H J, Claussen C D
Department of Diagnostic Radiology, Eberhard-Karls-Universität Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany.
Cardiovasc Intervent Radiol. 1997 Mar-Apr;20(2):133-8. doi: 10.1007/s002709900121.
To assess the value of intraductal ultrasound (US) for lymph node staging in malignant biliary obstruction.
Eighteen patients with malignant extrahepatic obstruction were imaged during percutaneous bile duct drainage with a mechanically rotating US transducer at 12.5 MHz. Detectable lymph nodes were classified as malignant when two of three criteria (hypoechoic, rounded, conspicuous margins) were fulfilled. The results were compared with histopathological data in 8 patients and follow-up CT findings in 10 patients.
In 15 of 18 patients (83%) malignant lymph node involvement was suspected at intraductal US and in 5 of 18 patients (28%) during CT. Histopathological investigation after operation (n = 8) and follow-up CT studies (n = 10) revealed the presence of malignant nodal involvement in 13 of 18 (72%) patients. The sensitivity, specificity, and accuracy of transhepatic intraductal biliary US in determining merely the presence or absence of malignant lymph nodes without specific topographic assignment were 92%, 40%, and 78%, respectively.
These preliminary results suggest that intraductal US may develop into a promising adjunctive modality during percutaneous bile duct drainage in patients with suspected malignant regional lymph node involvement.
评估导管内超声（US）在恶性胆管梗阻淋巴结分期中的价值。
18例肝外恶性梗阻患者在经皮胆管引流期间，使用12.5MHz机械旋转超声换能器进行成像。当满足三个标准（低回声、圆形、边界清晰）中的两个时，可检测到的淋巴结被分类为恶性。将结果与8例患者的组织病理学数据和10例患者的CT随访结果进行比较。
18例患者中有15例（83%）在导管内超声检查时怀疑有恶性淋巴结受累，18例患者中有5例（28%）在CT检查时怀疑有恶性淋巴结受累。术后组织病理学检查（n = 8）和CT随访研究（n = 10）显示，18例患者中有13例（72%）存在恶性淋巴结受累。在不进行特定部位定位的情况下，经肝导管内胆管超声检查仅确定恶性淋巴结是否存在的敏感性、特异性和准确性分别为92%、40%和78%。
这些初步结果表明，对于怀疑有恶性区域淋巴结受累的患者，导管内超声可能会发展成为经皮胆管引流期间一种有前景的辅助检查方法。
