Background and purpose Cystic pituitary adenomas and cystic craniopharyngiomas may mimic Rathke cleft cysts when there is no solid enhancing component on magnetic resonance imaging (MRI). This study aims to investigate the efficiency of MRI findings in differentiating Rathke cleft cysts from pure cystic pituitary adenoma and pure cystic craniopharyngioma. Materials and methods 109 patients were included in this study (56 Rathke cleft cysts, 38 pituitary adenomas, and 15 craniopharyngiomas). Preoperative magnetic resonance images were evaluated using 9 imaging findings. These findings include intralesional fluid-fluid level, intralesional septations, midline /off-midline location, suprasellar extension, an intracystic nodule, a hypointense rim on T2-weighted images, ≥ 2 mm thickness of contrast-enhancing wall, T1 hyperintensity and T2 hypointensity. p < 0.01 was considered statistically significant. Results There was a statistically significant difference among groups for these 9 findings. Intracystic nodule and T2 hypointensity were the most specific MRI findings in differentiating Rathke cleft cyst from the others (98.1% and 100%, respectively). Intralesional septation and thick contrast-enhancing wall were the most sensitive MRI findings ruling out Rathke cleft cysts with 100% sensitivity. Conclusion Rathke cleft cysts can be distinguished from pure cystic adenoma and craniopharyngioma with the presence of an intracystic nodule, T2 hypointensity, the absence of the thick contrast-enhancing wall, and absence of intralesional septations.
Aim: The aim of this study was to evaluate the efficacy of CT lymphography in sentinel lymph node biopsy for early stage breast cancer and to investigate its contribution to the conventional blue-dye method.
Material and Method: A total of 47 patients with early stage breast cancer underwent preoperative CT lymphography for lymph node mapping before sentinel lymph node biopsy with blue-dye method. The lymph nodes identified by CT lymphography and/or blue-dye method were examined for metastatic involvement. The sentinel lymph node detection rates of CT lymphography and blue-dye method were compared using t-tests.
Results: The sentinel lymph node detection rate with blue-dye method (87.2%) was significantly higher than with CT lymphography (66.0%) (P=0.027). However, the combined method (blue-dye method and/or CT lymphography) increased the detection rate (95.7%) (P=0.267). Benign sentinel lymph nodes were detected more often with CT lymphography (P=0.366), while metastatic sentinel lymph nodes were detected more often with blue-dye method (P=1,000). Upper outer quadrant tumors were detected less successfully with CT lymphography and more successfully with blue-dye method (P=0.220 and P=0.674, respectively). The success rate of CT lymphography in younger patients (less than 50 years old) was higher compared to older patients (P=0.001).
Conclusion: CT lymphography was found to be insufficient as a standalone method for sentinel lymph node biopsy. However, it could be used as a complementary method to blue-dye method to increase the success of sentinel lymph node detection.
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