临床为 N0 的全喉切除术中隐匿性结节转移的放射学发现。

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-08-02 DOI:10.1002/hed.27889

Tyler G. Chan MPhil, Jaime Wicks MD, Ila Sethi MD, Jennifer Becker MD, David Brandon MD, Nicole C. Schmitt MD, Azeem Kaka MD, Brian Boyce MD, Harry Michael Baddour MD, Mark W. El-Deiry MD, Mihir R. Patel MD, Jennifer H. Gross MD

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引用次数: 0

摘要

简介：通过颈部成像报告和数据系统（NI-RADS）可以检测出临床为零的全喉切除术（TL）中的隐匿性结节病（OND）。然而，一些患者在最终病理检查中仍会发现OND：方法：对2009年至2021年间所有通过选择性颈部切除术（END）挽救TL的OND患者进行回顾性研究。重复CT和PET扫描解读，评估其术前影像学可疑特征：在接受END的81例挽救性TL患者中，12例（16%）患有OND，共发现26个隐匿性结节。病理结果显示，结节平均长度[SD]为0.6厘米[0.3]。在 CT 上，31%（26 个中的 8 个）的结节呈圆形形态。在 PET 上，大多数患者的 SUVmax 低于血池值。一名患者的 NI-RADS 评分为 2 分，其余患者的评分为 1.结论：再次复查术前成像时，隐匿性结节很隐蔽，很难识别。尽管对生存率没有明显影响，但进行END检查可提供预后信息。

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Radiologic findings of occult nodal metastasis during clinically-N0 salvage total laryngectomy

Introduction

Occult nodal disease (OND) during clinically-N0 salvage total laryngectomy (TL) can be detected with the Neck-Imaging-Reporting-and-Data-Systems (NI-RADS). However, some patients will still have OND revealed on final pathology.

Methods

A retrospective study on all patients who had OND during salvage TL with elective neck dissection (END) between 2009 and 2021 was performed. Repeat CT and PET scan interpretation was performed to evaluate their preoperative imaging for suspicious features.

Results

Among 81 salvage TL patients undergoing END, 12 (16%) had OND and a total of 26 occult nodes were identified. On pathology, the average node length [SD] was 0.6 cm [0.3]. On CT, 31% (8 of 26) had rounded morphology. On PET, most had SUV_max below blood pool. One patient scored NI-RADS 2; the rest scored 1.

Conclusions

On re-review of preoperative imaging, occult nodes were subtle and challenging to identify. Despite no clear impact on survival, performing an END may provide prognostic information.

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.