EBUS-TBİA ESNASINDA DOPPLER MOD İLE DEĞERLENDİRİLEN VASKÜLER İMAJ PATERNİNİN BENİGN VE MALİGN LENF NODU AYIRIMINDAKİ DEĞERİ

Yıl 2017, Cilt: 31 Sayı: 2, 87 - 92, 01.10.2017

Nilgün Yilmaz Demirci Can Öztürk

Öz

Giriş: Endobronşiyal ultrasonografi kılavuzluğunda transbronşial iğne aspirasyonu (EBUS-TBİA), lenf nodu tanısı için yüksek verim sağlayan minimal invaziv bir prosedürdür. Bu çalışmanın amacı benign ve malign lenf nodunun (LN) ayırıcı tanısında EBUS-TBİA sırasında lenf bezlerinin doppler mod özelliklerinin kullanımını değerlendirmektir. Gereç ve Yöntem: EBUS, altta yatan hastalığa bakılmaksızın mediastinal lenfadenopatisi bulunan 151 hastaya uygulandı. LN' nin özelliklerini öngörmek için şu kriterler değerlendirildi; çap, şekil, sınır özellikleri, ekojenite, merkezi hiler yapı ve kan akışı. Kan akımı ölçütleri histopatolojik sonuçlar ile korele edildi ve duyarlılık, özgüllük, pozitif ve negatif prediktif değerler (PPV ve NPV) hesaplandı. Bulgular: Yüz elli bir hastada 229 LN analiz edildi. LN' larının %83.3' ü malign, %16.7'si benign olarak değerlendirilmişti. Grade 0 ve I kanlanmayı "benign", Grade II ve III kanlanmayı "malign" olarak tanımladığımızda duyarlılık, özgüllük, NPV, PPV ve tanısal doğruluk oranı sırasıyla %83.2, %66.7, %69.7, %82.3 ve %74.0 idi. Tartışma: Rutin EBUS işlemleri sırasında ultrason kriterlerinin değerlendirilmesi kolaylıkla uygulanabilir ve tekrar edilebilir. Power / Renkli Doppler modu ile LN' nin kanlanmasının değerlendirilmesi klinisyene doğru hedefte zaman tasarrufu açısından yardımcı olacaktır.

Anahtar Kelimeler

Endobronşiyal ultrason, Doppler ultrasonografi, Mediastinal lenf nodu, metastaz

THE VALUE OF THE VASCULAR IMAGING PATTERN ASSESSED BY THE DOPPLER MODE DURING EBUS-TBNA IN DIFFERENTIATING BETWEEN BENIGN AND MALIGNANT LYMPH NODES

Öz

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high yield for lymph node diagnosis. The aim of this study was to assess the utility of doppler mode features of lymph nodes during EBUS-TBNA in differentiating benign and malignant lymph node (LN). Material and Methods: EBUS was performed in 151 patients with mediastinal lymphadenopathy irrespective of the underlying disease. The following criteria were evaluated to predict feature of LN: diameter, shape, distinct margin, echogenicity, central hilar structure and blood flow in a LN. Blood flow criteria were correlated with the histopathological results and the sensitivity, specificity, positivenegative predictive values (PPV and NPV) and diagnostic accuracy rate were calculated. Results: Two hundred twenty nine LN in 151 patients were analysed. 83.3% of LNs were found malignant, 16.7% of LNs were found benign. When we defined Grade 0 and I as benignand Grade II and III as malignant the sensitivity, specificity, NPV, PPV, and diagnostic accuracy rate were 83.2%, 66.7%, 69.7%, 82.3% and 74.0%, respectively. Discussion: The assessment of ultrasound criteria during routine EBUS examinations is feasible and reproducible. Vascular image patterns of LN using Power/Color Doppler mode will help the clinician in terms of time saving at right target.

Anahtar Kelimeler

Endobronchial ultrasound, Doppler ultrasound imaging, Mediastinal lymph node, metastasis

Kaynakça

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