Contribution of Kinetic Characteristics of Axillary Lymph Nodes to the Diagnosis in Breast Magnetic Resonance Imaging

Objective: To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes. Material and Methods: One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations post-processing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (-LHR) of dynamic curves characterizing the axillary lymph nodes were calculated. Results: A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, -LHR were calculated as 14%, 1.04, 0.76 respectively. Conclusion: Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients. Turkish Anahtar Kelimeler: Aksiller lenf bezleri, kinetik karakterler, manyetik rezonans goruntuleme, meme kanseri Amac: Calismamizda insan fetuslarinda Oddi sfinkteri'nin fetal donem boyunca morfometrik gelisiminin arastirilmasi amaclandi. Materyal ve Metod: Calismaya, yaslari 14andash;40 gebelik haftasi yasi arasinda degisen ve eksternal patolojisi veya anomalisi olmayan, toplam 113 adet insan fetusu (67 erkek, 46 kiz) dahil edildi. Fetuslarin genel eksternal olcumleri yapildiktan sonra abdomen diseksiyonu ile duodenum, pankreas ve Oddi sfinkteri'nin lokalizasyonu belirlendi. Duodenum ic duvarinda Oddi sfinkterinin yerlesim yerinden mikroskobik inceleme icin histolojik doku ornekleri alindi. Isik mikroskobisinde; her bir fetusta Oddi sfinkterini olusturan ductus koledocus ve ductus pankreatikus'tan total dis cap, lumen capi, kanallarin total duvar kalinligi ve kanallar arasi mesafe parametreleri olculdu. Her bir hafta ve trimester icin olcumlerin standart sapmalari hesaplandi. Bulgular: Olculen parametrelerden ductus koledocus duvar kalinligi haric diger parametreler ile gestasyonel yas arasinda anlamli korelasyon iliskisi vardi (palt;0.001). Koledok duvar kalinligi fetal donemin ilk yarisinda artarken, ikinci yarisinda koledok lumeninin genislemesinden dolayi miada dogru giderek azaliyordu. Cinsler arasinda parametreler yonunden fark bulunamadi (pagt;0.05). Sonuc: Calismamizda elde edilen verilerin, fetal donemde, intrauterin olgularda Oddi sfinkter bolgesinin gelisiminin degerlendirilmesine katkida bulunacagini dusunmekteyiz.