A Comparison of the Diagnostic Accuracy and Reliability of Subjective Grading and Computer-Aided Assessment of Intranodal Vascularity in Differentiating Metastatic and Reactive Cervical Lymphadenopathy
A Comparison of the Diagnostic Accuracy and Reliability of Subjective Grading and Computer-Aided Assessment of Intranodal Vascularity in Differentiating Metastatic and Reactive Cervical Lymphadenopathy
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DOI：
10.1055/s-0034-1384939
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发表时间：
2016-02-01
影响因子：
3.4
通讯作者：
Ahuja, A. T.
中科院分区：
文献类型：
--
作者：
Lam, J.;Ying, M.;Ahuja, A. T.
目的：超声是评估恶性颈淋巴结病的一种公认的影像检查方法。通过使用多普勒超声，可以评估结内血管。然而，超声波的主要局限性是对操作员的依赖。因此，本研究旨在评价和比较主观分级和计算机辅助评估结内血管在鉴别良恶性淋巴结中的准确性和可靠性。材料和方法：本研究回顾分析了99例颈部淋巴结的能量多普勒超声图像，并采用定性主观分级(QSG)和计算机辅助定量(QCA)方法评价结内血管的程度。结果：QCA法较QSG法具有更高的准确性(67.8%和61.9%，p<；0.05)和更高的特异性(73.3%和57.3%，p<；0.05)。使用QCA方法确定的结内血管指数，区分转移性和反应性颈淋巴结的最佳分界值为32%。结论：在评价结节内血运程度方面，QCA法较QSG法更准确、更可靠。
Purpose: Ultrasound is a well-established imaging modality in the assessment of malignant cervical lymphadenopathy. With the use of Doppler ultrasound, intranodal vascularity can be evaluated. However, the major limitation of ultrasound is operator dependency. Therefore, this study aimed to evaluate and compare the diagnostic accuracy and reliability of the subjective grading and computer-aided approach in assessing intranodal vascularity for the differentiation of benign and malignant lymph nodes.Materials and Methods: The present study retrospectively assessed 99 power Doppler ultrasound images of cervical lymph nodes and evaluated the degree of intranodal vascularity using qualitative subjective grading (QSG) and quantitative computer-aided (QCA) methods. The diagnostic accuracy of the two methods in distinguishing metastatic and reactive nodes and their inter-and intra-rater reliability in assessing intranodal vascularity were evaluated and compared.Results: The results showed that the QCA method was more accurate than the QSG method with a significantly higher sensitivity (67.8 % and 61.9 %, respectively, p < 0.05) and specificity (73.3 % and 57.3 %, respectively, p < 0.05). Using the intranodal vascularity index as determined by the QCA approach, the optimum cut-off to differentiate metastatic and reactive cervical lymph nodes was 32 %. The QCA method showed higher inter-and intra-rater reliability than the QSG method.Conclusion: In the assessment of the degree of intranodal vascularity, the QCA method was more accurate and reliable than the QSG method in distinguishing metastatic and reactive lymph nodes.