A Radiologic Grading System for Assessing the Radiographic Outcome of Treatment in Lymphatic and Lymphatic-Venous Malformations of the Head and Neck

背景和目的：在头部和颈部发现了三分之二的儿童淋巴畸形。尽管经常通过手术切除来管理，但经皮硬化疗法却越来越受欢迎。没有设计可再现的分级系统来根据放射学发现比较硬化疗法的结果。我们提出了基于MR成像的分级量表，以评估对硬化疗法的反应，并对其间的可靠性进行评估。

材料和方法:A grading system was developed to stratify treatment outcomes on the basis of interval changes observed on MR imaging. By means of this system, 56 consecutive cases from our institution with formally diagnosed head and neck lymphatic malformations treated by sclerotherapy were retrospectively graded. Each patient underwent pre- and posttreatment MR imaging. Each study was evaluated by 3 experienced neuroradiologists. Interrater reliability was assessed using the Krippendorff α statistic, intraclass coefficient, and 2-way Spearman ρ correlation.

结果：总体Krippendorffα统计量为0.93（95％CI，0.89–0.95），表示评估者之间的一致性很高。相对于一致性和绝对协议的类内系数均为0.97（95％CI，0.96–0.98），说明了较低的变异性。单个评估者对的每种组合都表现出统计学意义（P< .01) linear Spearman ρ correlations, with values ranging from 0.90 to 0.95.

结论：拟议的放射学渐变量表表现出极好的界面可靠性。采用这种新量表可以在硬化疗法的头颈淋巴结畸形后标准化报告的结果，并可能有助于调查有关这些病变最佳管理的未来问题。