背景:中线颈部肿胀在儿童中非常常见,主要由甲状舌管囊肿(TGDCs)或皮样囊肿(DCs)引起。由于DC可以进行简单的切除,而TGDC需要通过Sistrunk程序进行更彻底的切除,术前区分两者很重要.以前的研究已经提出了一个超声评分(SIST)基于存在的隔膜,墙壁不规则和固体组件可以这样做。本研究旨在评估该评分的诊断准确性。
方法:回顾性纳入了在2006年至2018年期间在我们的三级中心接受中线颈部肿块手术且组织病理学诊断为TGDC或DC的所有患者(≤18岁)。术前超声由经验丰富的放射科医生和SIST以及位置进行评估。tract,回声,对边缘和多房性进行评分。
结果:我们包括97名儿童,其中67人(69%)患有TGDC。SIST显示出37%的灵敏度,97%的特异性,在检测TGDC时,SIST评分的阳性预测值为96%,阴性预测值为35%,这导致了0.67的AUC。此外,内部回声性(P<0.01)和边缘定义(P<0.01)与TGDC诊断显着相关,而Bonferroni校正后,位置和多房性被认为不重要。
结论:我们得出结论,SIST评分似乎非常有能力在TGDC中统治。然而,术前SIST评分远未明确区分DC和TGDC.添加其他超声变量,如边缘定义和回声,可能会提高诊断的准确性,需要进一步的研究。
BACKGROUND: Midline neck swellings are very common in children and mostly caused by thyroglossal duct cysts (TGDCs) or dermoid cysts (DCs). Since DCs can undergo simple excision, whilst TGDCs demand more thorough resection via Sistrunk procedure, it is important to differentiate between both pre-operatively. Previous studies have suggested an ultrasound-score (SIST) based on presence of septae, wall irregularity and solid components could do so. This study aims to evaluate the diagnostic accuracy of this score.
METHODS: All patients (≤18 years) undergoing surgery between 2006 and 2018 for a midline neck mass at our tertiary centre with a histopathological diagnosis of TGDC or DC were retrospectively included. The pre-operative ultrasound was evaluated by an experienced radiologist and the SIST as well as location, tract, echogenicity, margin and multilocularity were scored.
RESULTS: We included 97 children, of whom 67 (69 %) with TGDCs. The SIST showed a sensitivity of 37 %, specificity of 97 %, a positive predictive value of 96 % and a negative predictive value of 35 % for the SIST-score in detecting TGDCs, which resulted in an AUC of 0.67. In addition, internal echogenicity (P < 0.01) and margin definition (P < 0.01) were significantly associated to TGDC diagnosis whilst location and multilocularity were deemed insignificant following Bonferroni correction.
CONCLUSIONS: We conclude that the SIST-score seems very capable to rule in TGDC. However, the SIST-score is far from making a clear distinction between DC and TGDCs preoperatively. The addition of other ultrasound variables, such as margin definition and echogenicity, might increase the diagnostic accuracy and demands further research.