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Cervical lymphadenopathy in children: a diagnostic tree analysis model based on ultrasonographic and clinical findings.
- Source :
-
European radiology [Eur Radiol] 2020 Aug; Vol. 30 (8), pp. 4475-4485. Date of Electronic Publication: 2020 Mar 18. - Publication Year :
- 2020
-
Abstract
- Objectives: To establish a diagnostic tree analysis (DTA) model based on ultrasonography (US) findings and clinical characteristics for differential diagnosis of common causes of cervical lymphadenopathy in children.<br />Methods: A total of 242 patients (131 boys, 111 girls; mean age, 11.2 ± 0.3 years; range, 1 month-18 years) with pathologically confirmed Kikuchi disease (n = 127), reactive hyperplasia (n = 64), lymphoma (n = 24), or suppurative lymphadenitis (n = 27) who underwent neck US were included. US images were retrospectively reviewed to assess lymph node (LN) characteristics, and clinical information was collected from patient records. DTA models were created using a classification and regression tree algorithm on the basis of US imaging and clinical findings. The patients were randomly divided into training (70%, 170/242) and validation (30%, 72/242) datasets to assess the diagnostic performance of the DTA models.<br />Results: In the DTA model based on all predictors, perinodal fat hyperechogenicity, LN echogenicity, and short diameter of the largest LN were significant predictors for differential diagnosis of cervical lymphadenopathy (overall accuracy, 85.3% and 83.3% in the training and validation datasets). In the model based on categorical parameters alone, perinodal fat hyperechogenicity, LN echogenicity, and loss of fatty hilum were significant predictors (overall accuracy, 84.7% and 86.1% in the training and validation datasets).<br />Conclusions: Perinodal fat hyperechogenicity, heterogeneous echotexture, short diameter of the largest LN, and loss of fatty hilum were significant US findings in the DTA for differential diagnosis of cervical lymphadenopathy in children.<br />Key Points: • Diagnostic tree analysis model based on ultrasonography and clinical findings would be helpful in differential diagnosis of pediatric cervical lymphadenopathy. • Significant predictors were perinodal fat hyperechogenicity, heterogeneous echotexture, short diameter of the largest LN, and loss of fatty hilum.
- Subjects :
- Adolescent
Biopsy, Fine-Needle
Biopsy, Large-Core Needle
Child
Child, Preschool
Erythema physiopathology
Female
Fever physiopathology
Histiocytic Necrotizing Lymphadenitis pathology
Histiocytic Necrotizing Lymphadenitis physiopathology
Humans
Image Processing, Computer-Assisted
Infant
Lymph Nodes diagnostic imaging
Lymph Nodes pathology
Lymphadenitis diagnostic imaging
Lymphadenitis pathology
Lymphadenitis physiopathology
Lymphadenopathy pathology
Lymphadenopathy physiopathology
Lymphoma pathology
Lymphoma physiopathology
Male
Neck
Pseudolymphoma pathology
Pseudolymphoma physiopathology
Reproducibility of Results
Retrospective Studies
Ultrasonography
Ultrasonography, Doppler, Color
Algorithms
Diagnosis, Differential
Histiocytic Necrotizing Lymphadenitis diagnostic imaging
Lymphadenopathy diagnostic imaging
Lymphoma diagnostic imaging
Pseudolymphoma diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 30
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 32189052
- Full Text :
- https://doi.org/10.1007/s00330-020-06794-w