| 王晓荣,艾迪拜•木合买提,贾芳,宋涛.颈部肿大淋巴结恶性风险评估的超声分级诊断初步研究[J].中国医学影像技术,2020,36(4): |
| 颈部肿大淋巴结恶性风险评估的超声分级诊断初步研究 |
| Preliminary study of ultrasonographic classification diagnoses for evaluating malignant risk of cervical lymphadenopathy |
| 投稿时间：2019-04-30 修订日期：2020-04-21 |
| DOI： |
| 中文关键词: 超声，颈部淋巴结，恶性风险 |
| 英文关键词:Ultrasonograhy Cervical lymphadenopathy Malignant risk |
| 基金项目:新疆维吾尔自治区自然科学基金 |
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| 中文摘要: |
| 目的：建立可评估颈部肿大淋巴结（lymph node, LN）恶性风险的常规超声（Ultrasonography, US）分级诊断标准。方法：回顾性分析882个颈部肿大LN的四项常规US声像图指标（门髓质回声、内部回声、血流类型、L/S值）并对每个LN进行评分，然后按照各分值组中恶性LN的比例差异提出分级诊断标准。结果：颈部肿大淋巴结US声像图的总评分值范围是0~7分，随着分值的升高，恶性LN比例随之升高（P＜0.05），LN恶性风险的OR值亦随之升高。颈部肿大LN的常规US分级诊断标准：1级（0分）—极低度恶性风险、，恶性比例＜3.70%；2级（1~2分）—低度恶性风险、，恶性比例（14.91±4.63）%；3级（3~4分）—中度恶性风险、，恶性比例（43.89±0.64）%；4级（5~7分）—高度恶性风险、，恶性比例（77.84±9.15）%。若以“4级”作为判定颈部肿大LN良恶性的标准， Se=79.08.97%，SPp=72.54%，Youden指数=0.515，符合率为76.08%，ROC曲线下面积为0.791。结论：以常规US声像图评分为基础建立的颈部肿大LN分级诊断标准，对LN良恶性的鉴别能力较好，亦能为颈部肿大LN的超声诊断提供恶性风险预测。 |
| 英文摘要: |
| Objctive: The aim of this study was to establish an ultrasonographic (US) classification criterion for evaluating malignant risk of cervical lymphadenopathy. Objctive: The aim of this study was to establish an ultrasonographic (US) classification criterion for evaluating malignant risk of cervical lymphadenopathy. Methods: The four sonographic indexes of 882 cervical lymph nodes (LNs) were retrospectively studied, which were echogenicity of hilum, intranodal echogenicity, intranodal vascular pattern and the ratio of long axis to short axis (L/S), and each LN was given scores finally. Then, the US classification criterion was proposed according to the differences of the percentage of malignant LNs with the same score. Results: The score range of the US criterion was from 0 to 7. The percentage of malignant LNs was increasing with the scores (P＜0.05) and the OR values of malignant risk were also increasing. The US classification diagnostic criterion for the cervical lymphadnopathy was as follows: grade1 (0 score) - very low malignant risk, malignant percentage was less than 3.70%；grade 2 (1~2 score) - low malignant risk, malignant percentage was (14.91±4.63)%; grade 3 (3~4 score ) - moderate malignant risk, malignant percentage was (43.89+0.64)%；grade4 (5~7 score) - high malignant risk, malignant percentage was (77.84±9.15)%. If the cut-off value was “grade 4” for differentiating benign and malignant LNs, the sensitivity was 78.97%， specificity was 72.51%，Youden’s index was 0.515，coincidence rate was 76.08%，the AUC of this classification criterion was 0.791. Conclusions: The US classification diagnoses based on the sonographic socre criterion can better differentiate between benign and malignant LNs, and evaluate the malignant risk of cervical lymphadenopathy. |
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