Kaiser评分对乳腺BI-RADS 4类非肿块样强化病灶的诊断价值分析

Analysis on Kaiser Sore in Diagnostic Value of BI-RADS 4 Types of Breast Non-masses Enhancement

目的探讨Kaiser评分对乳腺BI-RADS 4类非肿块样强化(NME)病灶良恶性的诊断价值。方法搜集行乳腺DCE-MRI检查的BI-RADS 4类NME病灶的患者资料,以手术或穿刺病理结果为金标准,分析Kaiser评分对NME诊断结果,采用ROC曲线评估Kaiser评分的诊断效能。结果符合纳入标准病灶162例,其中良性90例,恶性72例。以诊断效能最佳的Kaiser评分4分为界,诊断恶性NME的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为77.2%、98.6%、60%、66.4%、98.2%,曲线下面积为0.817(95%CI:0.752~0.882)。当Kaiser评分<3时,对BI-RADS 4类NME病变的诊断未出现假阴性结果,可以减少14.2%的病灶不必要的活检。结论 Kaiser评分为影像医师提供客观的诊断方法,对BI-RADS 4类NME病变具有较高的敏感性和准确性,可以减少不必要的活检。

Objective To investigate the diagnostic value of Kaiser Score on breast imaging report and data system(BI-RADS) 4 types of breast non-masses. Methods The patients data with BI-RADS 4 types of breast non-masses enhancement was collected.Using pathological diagnosis as gold standards, the difference was compared in Kaiser score and pathological results.Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic performance of the Kaiser Score. Results 162 lesion was meeting inclusion criteria, including 90 benign and 72 malignant lesions.When the cut-off was <3,14.2% of lesions could be avoided unnecessary biopsies without any false-negative cases.Based on the Kaiser score of 4 with the best diagnostic performance, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of Kaiser Score were 77.2%,98.6%,60%,66.4% and 98.2%,respectively.The area under curve(AUC) was 0.817(95%CI:0.752-0.882). Conclusion The Kaiser score has high sensitivity and accuracy in diagnosing BI-RADS 4 types of NME lesions, which can reduce unnecessary biopsy of the lesions and provide imaging physicians with an objective diagnosis method.