Etiological Analysis Of Cervical Lymph Node Enlargement In Children And Preliminary Applicationof Ultrasound Grading Diagnosis For Lymph Node Malignant Risk Assessment

Objective:To composition of lymph node diseases in children of different ages was analyzed,and the ultrasound imaging characteristics of Cervical lymph node enlargement caused by benign and malignant etiology were further discussed,and the malignant risk value of Cervical lymph node enlargement in children was predicted by ultrasonic grading diagnosis,so as to provide some reference for the diagnosis of CLN diseases in children.Method:The clinical,pathological and ultrasonographic data of 434 children(age≤14 years)were analyzed.By age,they were divided into three groups: early childhood group,early school age group,school age group and adolescent group,and the etiology of each group was analyzed;Afterwards,evaluation of ultrasonographic characteristics of CLN enlargement due to benign and malignant etiology;Further,Sensitivity,specificity,coincidence rate and Youden index of ultrasonographic classification in diagnosis of cervical enlarged lymph nodes in children.Logistics regression analysis was used to compare the malignant risk prediction ability between graded diagnostic criteria and 4conventional ultrasound indicators(L/S,portal medullary echo,blood flow type,and internal echo).Results:Hyperplasia of reactivity lymph node phlogistic,infectious mononucleosis,kawasaki disease,langerhans cells hyperplasia,disease,lymphoma,leukemia affects lymph nodes,metastatic lymph nodes were preschool in the most rare,and necrotizing lymphadenitis tissue cells to school-age children,TB in puberty.The sonograms of benign CLN in children showed L/S≥2(70.7%,224/317),wide and middle(65.6%,208/317)hilar medulla echo,uniform internal echo(76.3%,242/317),and central portal blood flow(83%,263/317).L/S<2(59.6%,65/109),abnormal hilar and medulla echocardiography(62.4%,68/109),abnormal internal echocardiography(66.9%,73/109),mixed and peripheral blood flow(47,7%,52/109)and slightly more common are the characteristics of malignant CNL in children.In the grading diagnosis of cervical enlargement,grade 3 and 4 were malignant LN and grade 1 and 2 were benign LN.The sensitivity,specificity,AUC and Youden indexes were 77.60%,88.99%,0.833 and 0.666,respectively.The ability of Logistics regression analysis to distinguish benign and malignant LN was: grading diagnostic criteria,blood flow type,internal echo,portal medullary echo,L/S in descending order.Conclusion:The disease composition ratio of cervical enlarged lymph nodes in children of different ages was different.There were significant differences in L/S,portal medullary echo,internal echo and blood flow types between benign and malignant CLN(P<0.05);Ultrasonographic classification criteria have good application value in children.