超声分级诊断评估颈部肿大淋巴结恶性风险  

Ultrasonographic classification for evaluating malignant risk of cervical lymphadenopathy

作　　者：王晓荣[1] 艾迪拜·木合买提[1] 贾芳 宋涛[1] WANG Xiaorong;AIDIBA·Muhemaiti;JIA Fang;SONG Tao(Department of Ultrasound,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院超声诊断科,新疆乌鲁木齐830054

出　　处：《中国医学影像技术》2020年第4期524-528,共5页Chinese Journal of Medical Imaging Technology

基　　金：新疆维吾尔自治区自然科学基金面上项目(2017D01C310)。

摘　　要：目的建立评估颈部肿大淋巴结(LN)恶性风险的常规超声分级诊断标准。方法回顾性分析882个颈部肿大LN的4项常规超声声像图指标,包括门髓质回声、内部回声、血流类型及长短径比(L/S)值,据以对每个LN进行评分并按照分值分组,根据各组中恶性LN比例差异提出分级诊断标准。结果颈部肿大LN的声像图总评分值范围0~7分,恶性LN比例随分值提高而升高(P<0.05),LN恶性风险OR值亦随之升高。颈部肿大LN常规超声分级诊断标准: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)%。以“4级”为标准判定颈部恶性肿大LN的敏感度78.97%,特异度72.54%,约登指数0.515,准确率76.08%,AUC为0.791。结论以常规超声声像图评分为基础建立的颈部肿大LN分级诊断标准鉴别良恶性LN的能力较好,并能预测其恶性风险。Objective To establish ultrasonographic(US)classification criterion for evaluating malignant risk of cervical enlarged lymph nodes(LN).Methods Four US indexes of 882 cervical enlarged LN were retrospectively studied,including 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.US classification criterion was proposed according to the differences of the percentage of malignant LN in each score group.Results The score range of US criterion was from 0 to 7.The percentage of malignant LN increased with the scores increasing(P<0.05),so did OR values of malignant risk.US classification diagnostic criterion for cervical enlarged LN was as follows:grade 1(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)%;grade 4(5-7 score),high malignant risk,malignant percentage was(77.84±9.15)%.Taken“grade 4”as the cut-off value for differentiating benign and malignant LN,the sensitivity was 78.97%,specificity was 72.51%,Youden's index was 0.515,accuracy was 76.08%,and the AUC was 0.791.Conclusion US classification based on US score criterion can differentiate benign and malignant LN and evaluate the malignant risk of cervical enlarged LN.

关 键 词：颈 淋巴结 超声检查 恶性风险 

分 类 号：R55[医药卫生—血液循环系统疾病] R445.1[医药卫生—内科学]