title: Localization of the sentinel lymph node in tongue VX2 carcinoma via indirect CT lymphography combined with methylene blue dye injection.
abstract: CONCLUSIONS
  Indirect computed tomography lymphography (CT-LG) combined with blue dye injection can locate the sentinel lymph node (SLN) in tongue carcinoma.
  
  
  OBJECTIVE
  To localize the SLN in tongue VX2 carcinoma using indirect CT-LG combined with methylene blue injection.
  
  
  METHODS
  Eighteen rabbits were placed into three groups: metastasis, hyperplasia, and control. Indirect CT-LG was performed with an iohexol injection into the tongue submucosa. CT images were acquired at 1, 5, and 15 min after injection. Methylene blue was injected into the same area 24 h after indirect CT-LG, followed by SLN identification and histopathological examination.
  
  
  RESULTS
  SLNs were visualized with an identification rate of 100%. SLN location identified using CT lymphography was confirmed by methylene blue dye. Control and hyperplastic enhanced SLNs were round or oval without any filling defects. Control rabbits had enhanced SLN attenuation values of 689.2 +/- 55.4 HU, 278.4 +/- 33.5 HU, and 71.7 +/- 9.2 HU at 1, 5, and 15 min after injection, respectively. Hyperplastic rabbits had values of 877.4 +/- 69.4 HU, 352.5 +/- 43.3 HU, and 80.2 +/- 11.5 HU. Filling defects were only observed in the ipsilateral metastatic SLNs of the metastasis group. CT attenuation values of the metastatic SLNs were 687.4 +/- 55.6 HU, 535.1 +/- 86.6 HU, and 282.3 +/- 19.4 HU at 1, 5, and 15 min, respectively, after iohexol injection. Metastatic lymph node attenuation values were significantly greater than those of the control or hyperplastic nodes at 5 (p < 0.001) and 15 min (p < 0.001) after injection.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, EENT Hospital, Fudan University, 83 FenYang Road, Shanghai, PR China. Haitaowu1103@hotmail.com
authors.forename: Haitao
authors.initials: H
authors.lastname: Wu
authors.forename: Haiyue
authors.initials: H
authors.lastname: Ying
authors.forename: Xiuyian
authors.initials: X
authors.lastname: Xi
authors.forename: Na
authors.initials: N
authors.lastname: Shen
authors.forename: Yilai
authors.initials: Y
authors.lastname: Shu
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Hoffman
authors.forename: Adam
authors.initials: A
authors.lastname: Rieves
authors.forename: Yian
authors.initials: Y
authors.lastname: Sha
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000818:Animals; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D004195:Disease Models, Animal; D004791:Enzyme Inhibitors / Q000008:administration & dosage; D007267:Injections; D008220:Lymphography / Q000295:instrumentation*; D008751:Methylene Blue / Q000008:administration & dosage; D011817:Rabbits; D021701:Sentinel Lymph Node Biopsy; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*
chemical_list: D004791:Enzyme Inhibitors; D008751:Methylene Blue