Combination of helical CT and Doppler sonography in the follow-up of patients with clinical N0 stage neck disease and oral cancer.
Combination of helical CT and Doppler sonography in the follow-up of patients with clinical N0 stage neck disease and oral cancer.
复制标题
螺旋CT和多普勒超声检查相结合对临床N0期颈部疾病和口腔癌患者的随访。
DOI：
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Takashi Nakamura
中科院分区：
文献类型：
--
作者：
S. Eida;M. Sumi;K. Yonetsu;Y. Kimura;Takashi Nakamura
背景和目的
正确诊断转移淋巴结对临床N 0期颈部疾病和口腔癌患者的随访具有重要意义。螺旋CT与多普勒超声联合应用有助于临床N 0期颈部疾病淋巴结转移的准确诊断。
方法
对58例临床N 0期颈部疾病患者的颈部进行了螺旋CT增强扫描和多普勒超声检查。在这些患者中，17例接受了手术;组织病理学证实颈部淋巴结转移。如果一个淋巴结符合转移性淋巴结的CT标准（短轴直径等于或大于每个颈部或中央淋巴结坏死水平的截止点），并且如果它没有表现出非转移性淋巴结的超声特征（正常的肺门回声和肺门血流），则诊断为转移性淋巴结。组织病理学证实存在转移。
结果
在随访期间，17例（29%）患者的转移性淋巴结经组织学证实。在17例转移性淋巴结患者的30个转移性淋巴结中，22个（73%）在第一年内出现，28个（93%）在前2年内出现; 20个是非转移性淋巴结发展而来，10个是新检测到的。联合标准有效地显示了26个（87%）淋巴结，敏感性为87%，特异性为100%，阳性预测值为100%，阴性预测值为99%。单独使用这些技术之一，导致低（67%）或中度（87%）的阳性预测值超声和CT，分别。在761个初次检查时无转移的淋巴结中，有741个（97%）仍然无转移（737个淋巴结）或消失（4个淋巴结）。因此，CT和超声检查的结合是有效的显示所有17例转移性淋巴结。
结论
螺旋CT增强扫描结合多普勒超声检查对临床N 0期颈部病变的随访研究有重要价值。
BACKGROUND AND PURPOSE
Correctly diagnosing metastatic nodes is important for the follow-up of patients with clinical N0 stage neck disease and oral cancer. A combination of helical CT and Doppler sonography may facilitate the accurate detection of lymph node metastasis in patients with clinical N0 stage neck disease.
METHODS
A combination of contrast-enhanced helical CT and Doppler sonography was performed to monitor the necks of 58 patients with initial clinical N0 stage neck disease. Of these patients, 17 underwent surgery; nodal metastasis in the neck was histopathologically confirmed. A node was diagnosed as metastatic if it fulfilled the CT criteria for metastatic nodes (short-axis diameter equal to or greater than the cutoff points for each level of the neck or central nodal necrosis) and if, additionally, it did not exhibit sonographic features for nonmetastatic nodes (normal hilar echogenicity and hilar flows). The presence of metastasis was confirmed histopathologically.
RESULTS
During the follow-up periods, metastatic nodes were histologically confirmed in 17 (29%) patients. Of 30 metastatic nodes from the 17 patients with metastatic nodes, 22 (73%) appeared within the first year and 28 (93%) within the first 2 years; 20 developed from nonmetastatic nodes, and 10 were newly detectable. The combined criteria were effective in revealing 26 (87%) nodes, yielding 87% sensitivity, 100% specificity, and 100% positive and 99% negative predictive values. The independent use of one of these techniques alone resulted in low (67%) or moderate (87%) positive predictive values for sonography and CT, respectively. Seven hundred forty-one (97%) of 761 nodes that were nonmetastatic at initial examination remained nonmetastatic (737 nodes) or had disappeared (four nodes). As a result, a combination of CT and sonography was effective in revealing all 17 cases of metastatic nodes.
CONCLUSION
A combination of contrast-enhanced helical CT and Doppler sonography is useful for the follow-up study of clinical N0 stage neck disease.
影响因子：
19.7
作者：
JABOUR, BA;CHOI, Y;ABEMEYOR, E
通讯作者：
ABEMEYOR, E