Document Detail


Magnetic resonance imaging versus clinical palpation in evaluating cervical metastasis from head and neck cancer.
MedLine Citation:
PMID:  10964315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We prospectively compared the value of MRI and clinical palpation for detecting cervical metastases in patients with primary cancer of the head and neck. Sixty patients with squamous cell carcinoma of the upper aerodigestive tract were evaluated with MRI and clinical palpation before undergoing a total of 81 neck dissections. The results of preoperative clinical palpation and MRI were compared with the histopathologic outcome. The sensitivity and specificity were 75.6% and 97.5%, respectively, for clinical palpation and 73.2% and 95%, respectively, for MRI. The rate of occult cervical metastasis was 24% with clinical palpation and 26.8% with MRI. The use of MRI did not improve the rate of early detection of occult metastasis, nor did it improve the detection of extracapsular spread. Our findings show that we could not depend on palpation or MRI alone to determine the need for elective neck dissection. However, MRI can be used to improve the preoperative grading of cervical lymph nodes. In selected cases, this may direct surgeons to convert the treatment plan to choose a more conservative neck dissection or, after sentinel node sampling and frozen-section control, to convert the treatment to a more radical dissection.
Authors:
S P Hao; S H Ng
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  123     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-05     Completed Date:  2000-10-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  324-7     Citation Subset:  IM    
Affiliation:
Departments of Otolaryngology and Radiology, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Head and Neck Neoplasms / pathology*
Humans
Lymph Node Excision
Lymphatic Metastasis / diagnosis*
Magnetic Resonance Imaging*
Neck
Palpation*
Prospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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