摘要
目的:探讨Kaiser评分鉴别诊断乳腺影像报告和数据系统(BI-RADS)4类亚厘米肿块的临床应用价值。方法:回顾性搜集经病理证实的BI-RADS 4类亚厘米肿块患者173例,由3位乳腺诊断医师依据评分流程图进行盲法评估,通过ROC曲线分析诊断准确率。评估不同ADC阈值对评分的影响,不同ADC阈值的AUC比较行DeLong检验。结果:173例中,良性67例,恶性106例。Kaiser评分诊断亚厘米肿块的敏感度、特异度、准确率、阳性预测值、阴性预测值、阳性似然比、阴性似然比和AUC分别为90.6%~92.5%、62.7%~68.7%、80.9%~82.7%、79.7%~82.2%、81.5%~84.0%、2.48~2.92、0.12~0.14、0.801~0.830。以1.4×10-3 mm2/s作为ADC阈值,Kaiser评分的诊断准确率和AUC均最高,但不同ADC阈值的AUC之间差异无统计学意义(P>0.05)。结论:Kaiser评分诊断BI-RADS 4类亚厘米肿块性能良好,以1.4×10-3 mm2/s作为ADC阈值对Kaiser评分的辅助诊断价值更优。
Objective:To explore the clinical application value of Kaiser score in the differential diagnosis of breast sub-centimeter masses of BI-RADS Category 4 by MRI.Methods:A total of 173 patients with breast sub-centimeter masses of BI-RADS Category 4 were retrospectively collected.3 radiologists evaluated the lesions according to the scoring flow chart,and ROC curve was used to analyze the diagnostic accuracy.The impact of different ADC thresholds on scores was evaluated,and DeLong test was used to compare the differences between different AUC thresholds.Results:Among the 173 patients,67 cases were benign and 106 cases were malignant.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value,positive likelihood ratio,negative likelihood ratio and AUC of Kaiser score in the diagnosis of sub-centimeter masses were 90.6%~92.5%,62.7%~68.7%,80.9%~82.7%,79.7%~82.2%,81.5%~84.0%,2.48~2.92,0.12~0.14 and 0.801~0.830,respectively.Using 1.4×10-3 mm2/s as the ADC threshold,the diagnostic accuracy and AUC of Kaiser score were higher than those of the other thresholds,but AUC of the different ADC thresholds had no significant differences(P>0.05).Conclusions:Kaiser score has a good performance in the diagnosis of the sub-centimeter masses of BI-RADS Category 4.In addition,an ADC threshold of 1.4×10-3 mm2/s is also suitable for sub-centimeter masses.
作者
杜亮
张睿馨
徐可佩
方珍
洪敏萍
周长玉
许茂盛
DU Liang;ZHANG Ruixin;XU Kepei;FANG Zhen;HONG Minping;ZHOU Changyu;XU Maosheng(Department of Radiology,First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310001,China)
出处
《中国中西医结合影像学杂志》
2023年第6期656-662,共7页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
杭州市卫生科技项目(A20220800)
浙江中医药大学科研项目(2022JKZKTS39)。
关键词
乳腺亚厘米肿块
乳腺影像报告和数据系统
磁共振成像
Kaiser评分
诊断
鉴别
Breast subcentimeter masses
Breast imaging reporting and data system
Magnetic resonance imaging
Kaiser Score
Diagnosis,differential
