Ultrasonographic classification for evaluating malignant risk of cervical lymphadenopathy / 中国医学影像技术

ABSTRACT

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.