Mediastinal ve hiler lenfadenopatilerde endobronşiyal ultrason eşliğinde kullanılan power Doppler modunun benign ve malign lenf nodu ayırımına katkısı

Year 2020, Volume: 4 Issue: 1, 37 - 42, 02.03.2020

Ruşen Uzun , Canan Sadullahoğlu

https://doi.org/10.30565/medalanya.632623

Cited By: 1

Abstract

Amaç: Bu çalışma ile konveks prob endobronşiyal ultrasonografi (EBUS) eşliğinde tanısal amaçlı ince iğne aspirasyon yapılan olgularda, power Doppler modunun mediastinal ve hiler lenfadenopatilerde malign ve benign ayrımına katkısı araştırıldı.

Gereç ve Yöntemler: Mart 2018 ile Şubat 2019 tarihleri arasında EBUS yapılan olguların tıbbi dosyaları retrospektif olarak incelendi. Toplam 85 olguya ait 143 lenf nodunun örnekleme sonuçları çalışmaya dahil edildi. Kesin tanısı olan olguların demografik özellikleri, örneklenen lenf bezlerinin EBUS’daki radyolojik ve sonografik özellikleri kayıt edildi. Mediastinal lenf nodlarının EBUS ile değerlendirilmesi sonucunda power Doppler modunun malign lenf nodu belirlemedeki duyarlığı, özgüllüğü, negatif ve pozitif prediktif değeri hesaplandı.

Bulgular: Çalışmaya dahil edilen 85 hastanın 62’si (%73) erkek ve 23’ü (%27) kadın olup, yaş ortalaması 62±10,4 (dağılım: 37-80) yıl idi. Vasküler patern değerlendirmesi sonucunda malignite açısından negatif lenf nodu sayısı 87 (%60,8) iken, pozitif olarak değerlendirilen lenf nodu sayısı 56 (%39,2) olarak saptandı. Kesin tanıları ile vasküler patern analizi karşılaştırıldığında, EBUS eşliğinde kullanılan power Doppler modunun benign ve malign lenf nodu ayrımında katkısı istatistiksel olarak anlamlı bulundu (p<0,01).

Sonuç: Konveks prob EBUS, eş zamanlı görüntülemeye ve transbronşiyal ince iğne aspirasyon uygulamalarına olanak sağlamasının yanı sıra, lenf nodlarının sonografik özelliklerini tanımlayarak ilk örneklenecek lenf nodunu tespit edebilir. Bu da, işlem süresinin kısalmasını ve hastanın alacağı anestezi miktarının azalmasını sağlayabilir.

Keywords

Mediastinal lenf nodu, mediastinal evreleme, Power doppler, Ultrasonografi

The contribution of power Doppler mode of endobronchial ultrasound (EBUS) used in mediastinal and hilar lymphadenopathies in the differentiation of benign and malignant lymph nodes

Abstract

Aim: The aim of this study was to investigate the contribution of power Doppler mode used in the differentiation of malignant and benign lymph nodes in patients with mediastinal and hilar lymphadenopathies undergoing diagnostic fine needle aspiration under the guidance of convex probe endoscopic ultrasound (EBUS).

Material and Methods: Medical files of patients who underwent EBUS between March 2018 and February 2019 were retrospectively analyzed. A total of 143 lymph nodes of 85 patients were included in the study. The demographic characteristics of the patients with a definite diagnosis and EBUS radiological and sonographic characteristics of the sampled lymph nodes were recorded. As a result of the evaluation of mediastinal lymph nodes with EBUS, the sensitivity, specificity, negative and positive predictive values were calculated for power Doppler mode in the detection of malignant lymph nodes.

Results: Of a total of 85 patients, 62 (73%) were males and 23 (27%) were females with a mean age of 62±10.4 (range, 37 to 80) years. In the vascular pattern evaluation, 87 (60.8%) lymph nodes were negative and 56 (39.2%) were positive for malignancy. Comparing final diagnoses and vascular pattern analysis results revealed a statistically significant difference between benign and malignant lymph nodes in favor of power Doppler mode under the guidance of EBUS (p <0.01).

Conclusion: Convex probe EBUS can identify the first lymph node to be sampled based on sonographic characteristics of lymph nodes and allow simultaneous imaging and transbronchial fine needle aspiration procedures. Therefore, it may shorten the procedural time and reduce the amount of anesthesia to be used.

Keywords

Mediastinal lymph node, mediastinal staging, Power doppler, Ultrasonography

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