갑상선 유두암 환자의 수술 전 초음파유도하 경부림프절 표식의 유용성

• 영문명: Usefulness of Preoperative Ultrasound-guided Localization of Cervical Lymph Nodes with Skin Marking in Papillary Thyroid Cancer Patients
• 발행기관: 대한내분비외과학회
• 저자명: 배자성 정소령¹ 정찬권² 채병주 박우찬 송병주 김정수 정상설 Ja Seong Bae M.D. So-Lyung Jung M.D.¹ Chan-Kwon Jung M.D.² Byung Joo Chae M.D. Woo Chan Park M.D. Byung Joo Song M.D. Jeong Soo Kim M.D. and Sang Seol Jung M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』8권1호, 23~27쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2008.03.30

영문 초록

Purpose: To assess the value of preoperative ultrasonography (US) - guided skin marking for the investigation of cervical lymph node (LNs) metastasis in papillary cancer patients who had not undergone evaluation of cervical LNs at the initial diagnosis. Methods: We evaluated cervical lymph nodes in 40 patients with papillary thyroid cancer. Ultrasonography wasperformed just prior to surgery. The shape, echogenicity, size, and location of lymph nodes were noted and the location of lymph nodes was marked on the skin surface with a pen under ultrasound guidance. The retrieved lymph nodes underwent intraoperative frozen section analysis to plan the extent of surgery. Results: One hundred thirty two LNs were detected on preoperative US, 1087 LNs were surgically removed. Of 40 patients, 28 patients had lymph node metastasis. The cystic appearance, the presence of calcifications, hyperechogenicity and the absence of an echogenic hilum were significantly greater in malignant LNs than in benign LNs (P＜ 0.001). Among these, the cystic appearance and the presence of calcifications showed a very high specificity and seemed to be the most reliable in indicating malignant LNs. Conclusion: In papillary thyroid cancer patients, preoperatively ultrasound-guided localization of cervical LNs with skin marking shows good potential to determine surgical extent. Ultrasound features of LNs help in the selection of the node to remove with intraoperative frozen section analysis. (Korean J Endocrine Surg 2008;8:23-27)

키워드

갑상선 유두암, 초음파, 경부 림프절, 위치결정,Papillary thyroid cancer, Ultrasound, Cervical lymph nodes, Localization