Badanie ultrasonograficzne węzłów wartowniczych z użyciem środków kontrastujących

• Authors: XinWu Cui , Andre Ignee , Michael Bachmann Nielsen , Dagmar Schreiber-Dietrich , Chiara De Molo , Clara Pirri , Maciej Jedrzejczyk , Dietrich F. Christoph

Title variants

EN

Contrast enhanced ultrasound of sentinel lymph nodes

• Languages of publication: EN

Abstracts

EN

Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage
from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases
is critical in the staging of cancer, especially breast cancer and melanoma because
it directly affects patient’s prognosis and surgical management. Currently, intraoperative
sentinel lymph node biopsies using blue dye and radioisotopes are the method of
choice for the detection of sentinel lymph node with high identification rate. In contrast,
conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases.
Contrast enhanced ultrasound with contrast specific imaging modes has been used for the
evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy.
The method allows for real-time analysis of all vascular phases and the visualization of
intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells.
In recent years, a number of animal and human studies showed that contrast enhanced
ultrasound can be also used for the detection of sentinel lymph node, and may become
a potential application in clinical routine. Several contrast agents have been used in those
studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and
Definity®. This review summarizes the current knowledge about the use of ultrasound
techniques in detection and evaluation of sentinel lymph node.

PL

Węzły wartownicze są pierwszymi węzłami chłonnymi na drodze spływu chłonki z okolicy
guza pierwotnego. Wykluczenie lub potwierdzenie mikroprzerzutów w węźle wartowniczym
odgrywa istotną rolę w ustalaniu stanu zaawansowania nowotworu, szczególnie
nowotworu piersi i czerniaka, ponieważ bezpośrednio wpływa na rokowanie i wybór
metody chirurgicznego leczenia. Obecnie śródoperacyjna biopsja węzłów wartowniczych
z użyciem niebieskiego barwnika oraz radioizotopów są metodami z wyboru umożliwiającymi
zidentyfikowanie węzłów wartowniczych. W przeciwieństwie do biopsji standardowe
badanie ultrasonograficzne z reguły nie pozwala na ich uwidocznienie. Dzięki
badaniu ultrasonograficznemu z użyciem środka kontrastującego oraz opcji obrazowania
właściwych dla ultrasonografii ze środkami kontrastującymi można zdiagnozować
położone obwodowo nieprawidłowe węzły chłonne. Metoda ta umożliwia ocenę węzłów
w czasie rzeczywistym w każdej fazie naczyniowej, a także na uwidocznienie wewnątrzwęzłowych
ogniskowych obszarów „nieunaczynionych”, które reprezentują obszary martwicy
lub skupiska komórek nowotworowych. W ostatnich latach w wielu badaniach
przeprowadzanych na zwierzętach i u ludzi wykazano, że badanie ultrasonograficzne
z użyciem środka kontrastującego może uwidocznić węzeł wartowniczy i stać się rutynowym
badaniem diagnostycznym. W badaniach tych zastosowano kilka środków kontrastujących,
takich jak roztwór albuminy, skrobia hydroksyetylowana oraz SonoVue®,
Sonazoid® i Definity®. Niniejsza praca stanowi podsumowanie obecnej wiedzy dotyczącej
zastosowania ultrasonografii w diagnostyce węzłów chłonnych wartowniczych.

Keywords

EN

badanie ultrasonograficzne z użyciem środka kontrastującego; breast cancer; contrast enhanced ultrasound; czerniak; melanoma; microbubble contrast agents; mikropęcherzykowe środki kontrastujące; nowotwór piersi; preoperative staging; przedoperacyjna ocena stopnia zaawansowania nowotworu; sentinel lymph node; węzeł chłonny wartowniczy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Journal of Ultrasonography
• Year: 2013
• Volume: 13
• Issue: 52
• Pages: 73–81

Contributors

author

XinWu Cui

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Andre Ignee

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Michael Bachmann Nielsen

• Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

author

Dagmar Schreiber-Dietrich

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Chiara De Molo

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Clara Pirri

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Maciej Jedrzejczyk

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

author

Dietrich F. Christoph

• Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany

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• Document Type: article