Computed tomography and ultrasonography of metastatic cervical lymph nodes in oral squamous cell carcinoma.
Computed tomography and ultrasonography of metastatic cervical lymph nodes in oral squamous cell carcinoma.
复制标题
口腔鳞状细胞癌颈部转移淋巴结的计算机断层扫描和超声检查。
DOI：
10.1038/sj/dmfr/4600537
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
K. Shirasuna
中科院分区：
文献类型：
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作者：
K. Yuasa;T. Kawazu;T. Nagata;S. Kanda;M. Ohishi;K. Shirasuna
目的 明确CT和超声鉴别口腔鳞状细胞癌（SCC）颈部淋巴结转移的标准。材料和方法对147例口腔鳞状细胞癌患者的230个转移淋巴结和228个良性淋巴结进行CT和/或超声检查。将每个淋巴结的 CT 和 US 结果与组织病理学结果进行比较。 CT 上的转移定义为具有边缘或不均匀强化的淋巴结，或者在短轴上测量 10 毫米或以上，无论增强模式如何；在 US 上，转移定义为无论大小如何，有明确的内部回声，或没有明确的内部或肺门回声，但在短轴上测量 10 毫米或以上。具有肺门回声或长轴与短轴之比（L/S比）为3.5或以上的淋巴结被认为是良性的。不符合任何这些类别的淋巴结被认为是有问题的。结果 CT 的阳性预测值 (PPV) 为 90.8%，阴性预测值 (NPV) 为 70.4%。然而，65.7% 的淋巴结不能被分类为转移性或良性。美国的 PPV 为 96.5%，NPV 为 88.1%。所有淋巴结中的 25.5% 无法归类为转移性或良性。 结论 尽管在检测转移方面存在局限性，但通过纳入第三类“可疑”，我们的标准在临床上似乎比仅基于两组的其他当前方法更有用。
OBJECTIVESTo define criteria for CT and US in differentiating cervical lymph node metastases in oral squamous cell carcinoma (SCC).MATERIALS AND METHODSCT and/or US of 230 metastatic lymph nodes and 228 benign lymph nodes in 147 patients with oral SCC were retrospectively evaluated. The CT and US findings of each lymph node were compared with the histopathological findings. A metastasis was defined on CT as a lymph node with rim or heterogeneous enhancement, or measuring 10 mm or more in the short axis, regardless of enhancement pattern, and on US as having definite internal echoes, regardless of size, or without definite internal or hilar echoes, but measuring 10 mm or more in the short axis. A lymph node with hilar echoes or a ratio of the long to short axis (L/S ratio) of 3.5 or more was considered benign. A lymph node failing to comform to any of these categories was termed questionable.RESULTSThe positive predictive value (PPV) for CT was 90.8% and the negative predictive value (NPV) was 70.4%. However, 65.7% of all lymph nodes could not be classified as either metastastic or benign. PPV for US was 96.5% and NPV was 88.1%. 25.5% of all lymph nodes could not be classified as either metastatic or benign.CONCLUSIONSDespite limitations in detecting metastases, by including a third category 'questionable' our criteria appear clinically more useful than other current methods based on two groups only.