改进淋巴结- rads诊断鼻咽癌腮腺淋巴结转移的方法。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-25 DOI:10.1016/j.ejrad.2025.112451

Dongxia He , Hu Liang , Yishu Deng , Yingying Huang , Yixuan Wang , Nian Lu , Yuanji Xu , Zhizhong Lin , Zijie Wu , Yujun Hu , Chixiong Liang , Shuyu Wen , Youping Xiao , Chuanmiao Xie , Liangru Ke

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引用次数: 0

摘要

目的：建立一种改进的淋巴结报告和数据系统（mNode-RADS）来鉴别鼻咽癌（NPC）转移性和良性腮腺淋巴结（PLNs）。材料和方法：回顾性分析了两所医院166例和60例鼻咽癌合并PLN患者的资料。使用曲线下面积（AUC）比较转移性PLN （PLNM）的初始影像学特征的诊断性能。两个表现最好的变量，病变面积和短轴，被用来修改Node-RADS（分别为la-mNode-RADS和sa- mnode - rads）。比较短轴、常规和改进的Node-RADS标准的AUC、敏感性、特异性和准确性。结果：在内部队列中，病变区域的诊断价值最高（AUC = 0.877; cutoff = 60.69 mm2），其次是短轴（AUC = 0.869; cutoff = 7.5 mm）。la-mNode-RADS和sa-mNode-RADS的auc均高于Node-RADS（0.912或0.911比0.870，均p 0.05）。la-mNode-RADS和sa-mNode-RADS诊断鼻咽癌PLNM的准确率分别为87.0%和86.5%，均高于Node-RADS（80.0%）。

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Modifying node-RADS in diagnosing parotid lymph node metastasis of nasopharyngeal carcinoma

Objective

This study aimed to establish a modified Node Reporting and Data System (mNode-RADS) for differentiating metastatic from benign parotid lymph nodes (PLNs) in nasopharyngeal carcinoma (NPC).

Materials and methods

166 and 60 NPC patients with PLN from two institutions were retrospectively reviewed. The diagnostic performance of initial imaging characteristics for metastatic PLN (PLNM) was compared using the area under the curve (AUC). Two top-performing variables, lesion area and short axis, were used to modify Node-RADS (la-mNode-RADS and sa-mNoder-RADS, respectively). The AUC, sensitivity, specificity, and accuracy were compared among short axis, conventional and modified Node-RADS criteria.

Results

In the internal cohort, the lesion area showed the highest diagnostic performance (AUC = 0.877; cutoff = 60.69 mm²), followed by the short axis (AUC = 0.869; cutoff = 7.5 mm). Both la-mNode-RADS and sa-mNode-RADS achieved higher AUCs than Node-RADS (0.912 or 0.911 vs. 0.870; all p < 0.05). Dichotomized la-mNode-RADS and sa-mNode-RADS (scores 1–2 vs. 3–5) showed greater sensitivity than Node-RADS or short axis (94.8 % vs. 92.7 % vs. 76.0 % vs. 77.1 %; all p < 0.05), with similar specificity (78.7 % vs. 79.8 % vs. 84.3 % vs. 86.5 %; all p > 0.05). Both la-mNode-RADS and sa-mNode-RADS had higher accuracy than Node-RADS (87.0 % or 86.5 % vs. 80.0 %; all p < 0.05). No significant differences were observed between la-mNode-RADS and sa-mNode-RADS. The superior diagnostic performance of short-axis threshold of 7.5 mm and its corresponding mNode-RADS was also confirmed in external cohort.

Conclusions

The user-friendly sa-mNode-RADS shows superior diagnostic performance over traditional Node-RADS in detecting PLNM in NPC.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.