van den Brekel M W, Stel H V, Castelijns J A, Nauta J J, van der Waal I, Valk J, Meyer C J, Snow G B
Department of Otorhinolaryngology, Free University Hospital, Amsterdam, The Netherlands.
Radiology. 1990 Nov;177(2):379-84. doi: 10.1148/radiology.177.2.2217772.
To estimate the accuracy of different radiologic criteria used to detect cervical lymph node metastasis in patients with head and neck carcinoma, seven different characteristics of 2,719 lymph nodes in 71 neck dissection specimens from 55 patients were assessed. Three lymph node diameters, their location, their number, the presence of a tumor, and the amount of necrosis and fatty metaplasia were recorded. The minimal diameter in the axial plane was found to be the most accurate size criterion for predicting lymph node metastasis. A minimal axial diameter of 10 mm was determined to be the most effective size criterion. The size criterion for lymph nodes in the subdigastric region was 1 mm larger (11 mm). Groups of three or more borderline nodes were proved to increase the sensitivity but did not significantly decrease the specificity. Radiologically detectable necrosis (3 mm or larger) was found only in tumorous nodes and was present in 74% of the positive neck dissection specimens. Shape was not a valuable criterion for the radiologic assessment of the cervical lymph node status.
为评估用于检测头颈部癌患者颈部淋巴结转移的不同放射学标准的准确性，对55例患者71份颈部清扫标本中2719个淋巴结的7种不同特征进行了评估。记录了三个淋巴结直径、其位置、数量、肿瘤的存在情况以及坏死和脂肪化生的程度。发现轴平面上的最小直径是预测淋巴结转移最准确的大小标准。确定10mm的最小轴径是最有效的大小标准。二腹肌下区域淋巴结的大小标准大1mm（11mm）。三个或更多边界淋巴结组被证明可提高敏感性，但不会显著降低特异性。放射学上可检测到的坏死（3mm或更大）仅在肿瘤性淋巴结中发现，且在74%的阳性颈部清扫标本中存在。形状不是颈部淋巴结状态放射学评估的有价值标准。
