Contribution of Kinetic Characteristics of Axillary Lymph Nodes to the Diagnosis in Breast Magnetic Resonance Imaging

Abstract

Objective: To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes. Material and Methods: One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations post-processing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (-LHR) of dynamic curves characterizing the axillary lymph nodes were calculated. Results: A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, -LHR were calculated as 14%, 1.04, 0.76 respectively. Conclusion: Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients. Turkish Anahtar Kelimeler: Aksiller lenf bezleri, kinetik karakterler, manyetik rezonans görüntüleme, meme kanseri Amaç: Çalışmamızda insan fetuslarında Oddi sfinkteri'nin fetal dönem boyunca morfometrik gelişiminin araştırılması amaçlandı. Materyal ve Metod: Çalışmaya, yaşları 14–40 gebelik haftası yaşı arasında değişen ve eksternal patolojisi veya anomalisi olmayan, toplam 113 adet insan fetusu (67 erkek, 46 kız) dahil edildi. Fetusların genel eksternal ölçümleri yapıldıktan sonra abdomen diseksiyonu ile duodenum, pankreas ve Oddi sfinkteri'nin lokalizasyonu belirlendi. Duodenum iç duvarında Oddi sfinkterinin yerleşim yerinden mikroskobik inceleme için histolojik doku örnekleri alındı. Işık mikroskobisinde; her bir fetusta Oddi sfinkterini oluşturan ductus koledocus ve ductus pankreatikus'tan total dış çap, lümen çapı, kanalların total duvar kalınlığı ve kanallar arası mesafe parametreleri ölçüldü. Her bir hafta ve trimester için ölçümlerin standart sapmaları hesaplandı. Bulgular: Ölçülen parametrelerden ductus koledocus duvar kalınlığı hariç diğer parametreler ile gestasyonel yaş arasında anlamlı korelasyon ilişkisi vardı (p<0.001). Koledok duvar kalınlığı fetal dönemin ilk yarısında artarken, ikinci yarısında koledok lümeninin genişlemesinden dolayı miada doğru giderek azalıyordu. Cinsler arasında parametreler yönünden fark bulunamadı (p>0.05). Sonuç: Çalışmamızda elde edilen verilerin, fetal dönemde, intrauterin olgularda Oddi sfinkter bölgesinin gelişiminin değerlendirilmesine katkıda bulunacağını düşünmekteyiz.

Keywords

• Axillary lymph nodes, breast carcinoma, kinetic characteristics, magnetic resonance imaging

Contribution of Kinetic Characteristics of Axillary Lymph Nodes to the Diagnosis in Breast Magnetic Resonance Imaging

Öz

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