B-FLOW TWINKLING SIGN IN PREOPERATIVE EVALUATION OF CERVICAL LYMPH NODES IN PATIENTS WITH PAPILLARY THYROID CARCINOMA
Napolitano, Giuseppina (2011) B-FLOW TWINKLING SIGN IN PREOPERATIVE EVALUATION OF CERVICAL LYMPH NODES IN PATIENTS WITH PAPILLARY THYROID CARCINOMA. [Tesi di dottorato] (Inedito)
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Purpose: To evaluate the presence of B-Flow Imaging twinkling signs (BFI-TS) within metastatic lymph nodes in patients with papillary thyroid carcinoma. Materials and Methods: Between September 2006 and June 2011, two hundred fifty two patients with known PTC were examined, at our institution, for preoperative sonographic evaluation with gray-scale ultrasonography (US), color Doppler US and BFI-TS. Only Lns that were unequivocally matched between US and pathology were taken into account for our analysis. The patients with suspicious metastatic cervical LN at US examination underwent FNAB for cytology and thyroglobulin determination in the aspirate fluid. All patients included in our study underwent surgery, and the final diagnosis was based on the results of histologic examination of the resected specimens. The following LN characteristics were evaluated: short-axis diameter, short-to-long-axis diameter ratio, presence of echogenic hilum, hyperechogenic punctuations, presence of cystic appearance, peripheral vascularization and the presence of BFI-TS. Results: A total of 604 LNs were analyzed. 298 out of 604 were metastatic while the remaining 306 were benign, according to the histopathologic findings. Most ultrasound features had high specificity and PPV but low sensitivity and NPV. The only sonographic characteristic with high specificity and sensitivity values was the BFI-TS. Conclusions: Our results indicate that BFI can overcome the limits of the traditional B-mode and color Doppler sonographic features in the diagnosis of metastatic LNs in patients with PTC.
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