Figure - uploaded by Seda Aladağ Kurt
Content may be subject to copyright.
Flowchart for management of axillary lymph nodes with cortical enlargement

Flowchart for management of axillary lymph nodes with cortical enlargement

Source publication
Article
Purpose: To investigate the relationship between sonographic findings and the axillary status, especially the side of thickening in the presence of cortical asymmetry. Methods: Patients with biopsy-proven axillary lymph node (ALN) metastasis were included in this study. The lymph nodes were divided into three groups depending on the type of cortica...

Citations

... Compared to colour Doppler technology, SMI exhibits heightened sensitivity for microvasculature [16]. SMI is primarily used for evaluating thyroid, gynaecological, breast, liver, and kidney conditions [17][18][19][20][21], offering valuable insights into angiogenesis-related diseases to support diagnosis and treatment. The skin and subcutaneous tissues are rich in capillaries with small diameters and slow blood flow rates. ...
Article
Full-text available
Objectives To investigate microvascular changes in juvenile localised scleroderma (JLS) lesions using superb microvascular imaging (SMI) and assess SMI’s utility in evaluating disease activity. Methods This prospective study enroled 16 children (7 males) with pathologically diagnosed JLS between January 2021 and June 2023. Lesions were assessed using Localised Scleroderma Cutaneous Assessment Tools, including the localised scleroderma skin activity index (LoSAI) and localised scleroderma skin damage index (LoSDI). Lesions with LoSAI scores > 0 were classified as active. The thickness and blood flow of the lesions and healthy skin layers of the contralateral site were evaluated using ultrasound. SMI was used to detect microvascular blood flow in the lesions and healthy skin, and the vascular index (VI) was calculated. The difference in VI between active lesions and healthy skin was correlated with LoSAI and total scores. Results Of 46 lesions, 23 were active and 23 inactive. The skin thickness of the lesion was 0.094 ± 0.024 cm, and that of the healthy site was 0.108 ± 0.026 cm ( p < 0.001). The VI of the active lesions and healthy skin were 7.60 (3.60, 12.80)% and 1.10 (0.50, 2.10)%, respectively ( p < 0.001). The VI of the inactive lesions and the healthy skin were 0.85 (0.00, 2.20)% and 1.60 (1.00, 3.10)%, respectively ( p = 0.011). VI differences between active lesions and healthy skin positively correlated with the LoSAI clinical score ( r = 0.625, p = 0.001) and total score ( r = 0.842, p < 0.001). Conclusion SMI can quantitatively detect microvascular blood flow changes in JLS skin, indicating lesion activity and severity. Clinical relevance statement SMI is a convenient, non-invasive, technique for detecting active JLS lesions and can provide valuable information to guide treatment options. Key Points Current grading systems of juvenile localised scleroderma rely on subjective clinical information . Superb Microvascular Imaging identified that vascular indexes between active lesions and healthy skin positively correlated with clinical scores . Superb Microvascular Imaging effectively assesses microvascular blood flow, aiding juvenile localised scleroderma lesion activity evaluation .