摘要
目的对比分析Kaiser评分与表观扩散系数(apparent diffusion coefficient,ADC)对乳腺病灶的诊断效能及降低非必要活检的能力。材料与方法回顾性分析南方医科大学顺德医院2019年1月至2021年9月间行乳腺MRI检查的127例患者的临床及影像资料(共134个病灶,7例患者有2个病灶)。联合应用ADC和Kaiser评分得到KS+评分,应用ADC、Kaiser评分及KS+评分评价乳腺病灶。以病理结果为金标准,计算并比较Kaiser评分、ADC和KS+评分的曲线下面积(area under the curve,AUC)、敏感度、特异度,AUC通过Delong检验进行比较,敏感度、特异度通过McNemar检验进行比较。结果Kaiser评分的AUC(0.917)与ADC的AUC(0.812)差异有统计学意义(P=0.0404),两者AUC在非肿块病灶中差异最大。Kaiser评分的特异度(0.809)与ADC的特异度(0.426)差异有统计学意义(P=0.0215)。Kaiser评分的敏感度(0.954)与ADC的敏感度(0.977)差异无统计学意义(P=0.6875)。Kaiser评分的AUC(0.917)、敏感度(0.954)、特异度(0.809)与KS+评分的AUC(0.914)、敏感度(0.943)、特异度(0.830)差异均无统计学意义(P均>0.05)。结论Kaiser评分对乳腺病灶的诊断效能优于ADC,尤其是在评价乳腺非肿块病灶中Kaiser评分具有显著优势。Kaiser评分降低非必要活检的能力亦优于ADC,联合应用Kaiser评分和ADC无法提高诊断效能及降低非必要活检能力,Kaiser评分更适用于临床实践。
Objective:To compare the diagnostic performance of Kaiser score with apparent diffusion coefficient(ADC)to distinguish benign from breast malignant lesions and to assess the potential of those approaches to avoid unnecessary biopsies.Materials and Methods:This retrospective study enrolled 127 patients with 134 lesions(7 patients had 2 lesions)undergoing breast MRI from January 2019 to September2021.KS+score was calculated by combining ADC and Kaiser score.With pathological results as the gold standard,the area under the receiver operating characteristics curve(AUC)was calculated and compared between Kaiser score,ADC and KS+score through Delong Test.Sensitivity and specificity were calculated and compared between them through McNemar Test.Results:The AUC of Kaiser score(0.917)was significantly different from that of ADC(0.812)(P=0.0404),and the largest difference was found in non-mass lesions.There were statistically significant differences in specificity between Kaiser score(0.809)and ADC(0.426)(P=0.0215),but no difference in sensitivity between Kaiser score(0.954)and ADC(0.977)(P=0.6875).There were no differences between the AUC(0.917)、sensitivity(0.954)and specificity(0.809)of the Kaiser score and the AUC(0.914)、sensitivity(0.943)and specificity(0.830)of the KS+score(P>0.05).Conclusions:Kaiser score is superior to ADC in distinguishing benign from malignant breast lesions,especially in non-mass enhancement lesions.Kaiser score also performs better in avoiding unnecessary biopsies compared with ADC.The combination of the Kaiser score and ADC does not contribute to the diagnosis of breast cancer.
作者
潘佳玲
李晓虹
陈新杰
邓凌达
杜勇兴
陈海雄
杨少民
胡秋根
郭保亮
PAN Jialing;LI Xiaohong;CHEN Xinjie;DENG Lingda;DU Yongxing;CHEN Haixiong;YANG Shaomin;HU Qiugen;GUO Baoliang(Department of Radiology,Shunde Hospital of Southern Medical University(The First People's Hospital of Shunde,Foshan),Foshan 528300,China;Department of Radiology,Shunde Hospital affiliated to Guangzhou Medical University(YueCong Hospital of Shunde,Foshan),Foshan 528300,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2022年第6期108-111,116,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
广东省医学科研基金(编号:A2020395)
佛山市高层次医学人才培养(医学骨干人才)基金(编号:600024)。
关键词
乳腺
磁共振成像
Kaiser评分
表观扩散系数
breast
magnetic resonance imaging
Kaiser score
apparent diffusion coefficient
