Is invaziv attempt the only option for the differentation of malign and benign lenfadenopaty ?

Yıl 2012, Cilt: 3 Sayı: 1, 1 - 9, 31.07.2012

Ömer Yılmaz , Zeynep Balta Sevide Tunçbilek Uğur Koşar

Öz

Aim: The aim of the study is to evaluate efficacy of B mod US and colour dopler US on the seperator diaognosis of benign and malign servikal lymph nods by comparing İİAB results, and display the fact that whether colour doppler US has a great positive effect upon the diagnosis value of B mod US analysis when they are combined.

Material and Method: 37 patients were included into the study. B mod US and colour doppler US were practiced onto all the facts. The analysis was done with SDU2200 shimadzu Tokyo Japan colored doppler device by having the usage of 7.5 mhz lineer transduser. The biggest servikal lymph nod was added to study. The efficiency of B mod US and colour doppler US facts was rated in the values of sensibility, specifity, positive and negative provisions by taking the basis of hispatologic results.

Findings: In the fact that when the 37 patients that were taken up into the study, were evaluated with one of the B mod US and colour doppler US or with both of them, the lymph nods that take malign diagnosis are thought as malign, according to both investigations, when lymph nods that take benign diagnosis are assumed as benign, they are thought as 16 lymph nods malign and 21 lymph nods benign.

Conclusion: When rounded shape define for B mod US with malignancy, longitunidal/transvers diameter percentage, loss of hiler ekojenite, contour lobulation and lymph nods whose nekroz existence criterias are positive as at least two of those, are assumed as malign, the rates of sensitivite and spesifty are clearly high. In addition to these findings, it is thought that vaskuler patern and spectral wave analysis that is looked up into the benign and malign lymph nods, redoubles the rates of sensitivity and specifity and it is also thought that it decreases the number of false negative facts noticeably.

Anahtar Kelimeler

Cervical lymph node, Ultrasonography, Colour Doppler Ultrasonography

Malign ve Benign Lenfadenopati ayrımında invaziv girişim tek seçenek mi?

Öz

Amaç: Çalışmanın amacı benign ve malign servikal lenf nodlarının ayırıcı tanısında B mod US ve renkli doppler US bulgularının etkinliğini İİAB sonuçları ile karşılaştırarak değerlendirmek, kombine edildiklerinde renkli doppler US'nin B mod US incelemenin tanı değerine katkısı olup olmadığı ortaya koymaktır.
Gereç Yöntem: Çalışmaya 37 hasta dahil edildi. Tüm olgulara B-mod US ve renkli doppler US incelemeleri uygulandı. İnceleme SDU2200, Shimadzu, Tokyo, Japan renkli doppler cihazıyla 7.5 MHz'lik lineer transdüser prob kullanılarak yapıldı. Çalışmaya en büyük servikal lenf nodu dahil edildi. Histopatolojik sonuçlar temel alınarak B mod US ve renkli doppler US bulgularının etkinliği duyarlılık, özgüllük, pozitif ve negatif öngörü değerleri şeklinde hesaplandı.
Bulgular: Çalışmaya dahil edilen 37 olgunun B mod US ve renkli doppler US'den herhangi birisi ile ya da her ikisi birlikte değerlendirilmesinde; malign tanı almış lenf nodları malign, her iki incelemeye göre benign tanı alan lenf nodları benign kabul edildiğinde 16 lenf nodu malign, 21 lenf nodu benign olarak düşünülmüştür.
Sonuç: B mod US ile malignite için tanımlanan yuvarlak şekil, longitudinal/transvers çap oranı, hiler ekojenite kaybı, kontur lobülasyonu ve nekroz varlığı kriterlerinden en az ikisi pozitif olan lenf nodları malign kabul edildiğinde sensitivite ve spesifite oranları belirgin yüksek olup, bu bulgulara ek olarak benign ve malign lenf nodlarında bakılan vasküler patern ve spektral dalga analizinin sensitivite ve spesifite oranlarını arttırdığı ve yalancı negatif olgu sayısını belirgin şekilde azalttığı düşünülmüştür. 

Anahtar Kelimeler

Servikal lenf nodu, Ultrasonografi, Renkli Dopler Ultrasonograf

Kaynakça

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