Abstract：
OBJECTIVE:To evaluate the utility of different ultrasonographic (US) features in differentiating benign and malignant lymph node (LN) by endobronchial ultrasound (EBUS) and validate a score for real-time clinical application. METHODS:208 mediastinal LN acquired from 141 patients were analyzed. Six different US criteria were evaluated (short axis ≥10 mm, shape, margin, echogenicity, and central hilar structure [CHS], and presence of hyperechoic density) by two observers independently. A simplified score was generated where the presence of margin distinction, round shape and short axis ≥10 mm were scored as 1 and heterogeneous echogenicity and absence of CHS were scored as 1.5. The score was evaluated prospectively for real-time clinical application in 65 LN during EBUS procedure in 39 patients undertaken by two experienced operators. These criteria were correlated with the histopathological results and the sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. RESULTS:Both heterogenicity and absence of CHS had the highest sensitivity and NPV (≥90%) for predicting LN malignancy with acceptable inter-observer agreement (92% and 87% respectively). On real-time application, the sensitivity and specificity of the score >5 were 78% and 86% respectively; only the absence of CHS, round shape and size of LN were significantly associated with malignant LN. CONCLUSIONS:Combination of different US criteria can be useful for prediction of mediastinal LN malignancy and valid for real-time clinical application.
journal_name
Arch Bronconeumoljournal_title
Archivos de bronconeumologiaauthors
Shafiek H,Fiorentino F,Peralta AD,Serra E,Esteban B,Martinez R,Noguera MA,Moyano P,Sala E,Sauleda J,Cosío BGdoi
10.1016/j.arbres.2013.12.002subject
Has Abstractpub_date
2014-06-01 00:00:00pages
228-34issue
6eissn
0300-2896issn
1579-2129pii
S0300-2896(14)00002-7journal_volume
50pub_type
杂志文章abstract：:Airway complications after lung transplant are relatively common although the rates vary according to the different studies. Pathogenesis is diverse but the principal mechanism is usually bronchus intermedius ischemia in the post-transplant period. One major complication is bronchial stenosis, with relatively frequent...
journal_title：Archivos de bronconeumologia
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