title: Predictive ultrasound factors of lymphatic invasion in rectal cancer: "extra-corporeal" study.
abstract: OBJECTIVE
  the accuracy of preoperative endorectal ultrasound in the status evaluation of lymph nodes is around 50-70%, with a lack of eco-morphological patterns of clinical use. Since, accurate local staging is of great value in prognosis and decision-making we decided to analyze the referenced eco-morphological parameters in a try to find a proper predictive tool of clinical help that could improve the accuracy of rectal ultrasound.
  
  
  METHODS
  the resected specimens of 24 patients that were operated on by radical surgery because rectal cancer, without preoperative radiotherapy were suspended in warm water and ultrasound scanned (360º circular probe with a transducer of 10 Mhz). All suspicious nodes were recorded and marked for the definitive histological report.
  
  
  RESULTS
  from the 24 specimens, 318 nodes were imaged(210 benign and 100 involved). All ultrasound parameters analysed were significant but only lobulation, echogenicity and hilar reflection were independent values. An score system was design with the addition of all parameters that showed a sensitivity of 98%and specificity of 99,1%.
  
  
  CONCLUSIONS
  our study shows that a careful study of ultra-sound lymph node images can get a high level of accuracy and better help in tailoring the treatment of any particular case.
authors: Department of Surgery, Hospital Clínico Universitario de Zaragoza, Spain. jramirez@unizar.es
authors: J M
authors: JM
authors: Ramírez Rodríguez
authors: M J
authors: MJ
authors: Palacios Fanlo
authors: J
authors: J
authors: Ortego Fernández de Retana
authors: V
authors: V
authors: Aguilella Diago
authors: M
authors: M
authors: Martínez Díez
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D066298:In Vitro Techniques; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D012680:Sensitivity and Specificity; D014463:Ultrasonography