The purpose of this study is to evaluate the accuracy of gray scale and Doppler US findings in the detection of axillary metastases in breast cancer patients with no palpable lymph nodes. One-hundred and ninety-eight lymph nodes detected in 83 women were evaluated. The size and longitudinal/transverse axis ratios of each node were documented. Absence of echogenic hilum, asymmetrical cortical thickening, and presence of peripheral flow were prospectively considered signs of malignancy. Histopathologically, there were 93 malignant and 105 benign nodes. The above criteria and a low longitudinal-transverse axis ratio were statistically significant for malignancy. In lymph nodes smaller than 1 cm, only asymmetric cortical thickening and presence of peripheral flow were significant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 86.49, 93.62, 91.43, 89.8 and 90.48%, respectively. In conclusion, US is successful and reliable in the determination of axillary metastatic involvement in nonpalpable and small lymph nodes. Inclusion of axillary US in the preoperative diagnostic evaluation would be complimentary to sentinel node biopsy, and also could eliminate the need for it in patients with positive US results, after confirmation with biopsy.
Purpose: In this study, unlike the previous studies, and Power Doppler vocal fremitus test (PDVFT) is utilized and is evaluated in subcategories to assess its role in the differentiation of benign and malignant lesions. Materials and Methods Thorough the 161 lesions of 147 patients are included in this prospective study. During PDVFT, it is determined that eight different fremitus patterns have broken out according to the colour aliasing during patient's vocal phonation. It is also grouped as, according to the lesion color aliasing pattern during vibration: (c) for central, (p) for peripheral, (d) for perilesional-desmoplastic, (e) for eccentric, (h) for heterogenous-hierarchic, (s) for septal, (t) for total, (z) for absent-zero. Thereafter, the patterns and histopathological results of the lesions are correlated and analysed statistically. Results Out of 161 lesions, (benign: 133 and malignant, 28 cases) totally 189 patterns are encountered. None of the patterns z, t, s or e was detected in any of the malignant lesions. Specific values for different patterns have been obtained which changing between 29% and 100%. After adding the PDVFT finding, the newly generated BIRADS scheme has the accuracy value as high 91%. Conclusion When it is classified according to the colour aliasing pattern(s) of lesion in PDVFT; the "p" pattern is seen about the same ratio in both malign lesion and benign lesion (nonspecific patterns); "c, d, h" patterns mostly related with malignancy, whereas "e, s, t, z" patterns related with benignity. With adding the PDVFT findings; accuracy of well known BIRADS categorization and lesion demarcation were also improved successfully.
Dynamic PD-US may show the orientation of the hernia neck and any sign of incarceration more accurately and clearly than conventional GS-US. Being informed about these features preoperatively is of utmost importance. Thus, anterior abdominal wall hernias should be examined by dynamic PD-US.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.