Department of Ultrasonography, Tianjin Huanhu Hospital, Tianjin, China.
Department of Ultrasonography, Tianjin Huanhu Hospital, Tianjin, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Sep;134(3):386-396. doi: 10.1016/j.oooo.2022.05.002. Epub 2022 May 13.
The aim of this study was to compare the diagnostic efficacy of physical examination, ultrasound, and computed tomography for the detection of lymph node metastasis (LNM).
Patients with pathologically confirmed squamous cell carcinoma of the head and neck and who were not planned for surgery underwent preoperative physical examinations, ultrasound (US) scans, and computed tomography (CT) scans to detect LNM. Ultrasound-guided fine-needle aspiration cytopathology was the reference standard for calculating the diagnostic parameters.
US examination yielded fewer false-negative LNM (P = 0.0125) and higher sensitivity (P = 0.0313), specificity (P = 0.0078), and Youden index (P < 0.0001) than CT examination. The likelihood of detecting LNM with US, CT, and the combination of US and CT as measured in diagnostic confidence/lymph node was >0.718, >0.768, and >0.552, respectively. The combination of US and CT had the least risk of underdiagnosis and higher measures of diagnostic efficacy and predicting outcomes than all other index tests.
US has greater diagnostic efficacy than CT in detecting LNM for patients who have no clinical indication for surgery or decline surgical treatment. The combination of US and CT examinations may be a reliable noninvasive method.
本研究旨在比较体格检查、超声和计算机断层扫描（CT）在检测淋巴结转移（LNM）方面的诊断效能。
对经病理证实的头颈部鳞状细胞癌患者进行术前体格检查、超声（US）扫描和 CT 扫描，以检测 LNM。超声引导下细针抽吸细胞学检查是计算诊断参数的参考标准。
与 CT 检查相比，US 检查的假阴性 LNM 更少（P = 0.0125），且具有更高的灵敏度（P = 0.0313）、特异性（P = 0.0078）和 Youden 指数（P < 0.0001）。US、CT 和 US 联合 CT 检测 LNM 的诊断置信度/淋巴结的可能性分别为>0.718、>0.768 和>0.552。US 联合 CT 联合检查的漏诊风险最低，诊断效能和预测结果的各项指标均高于其他所有检查方法。
对于无手术指征或拒绝手术治疗的患者，US 检查在检测 LNM 方面比 CT 检查具有更大的诊断效能。US 联合 CT 检查可能是一种可靠的非侵入性方法。
