| 智文祥,陈亚青,李文英,蒋珺,张惠箴,何萍青.不同年资医师运用BI-RADS判断乳腺病灶特征的一致性[J].中国医学影像技术,2009,25(8):1384~1386 |
| 不同年资医师运用BI-RADS判断乳腺病灶特征的一致性 |
| Interobserver variability for characteristics of breast lesions between junior and senior radiologists with BI-RADS |
| 投稿时间：2009-04-10 修订日期：2009-05-02 |
| DOI： |
| 中文关键词: 超声检查 钼靶X线 乳腺病变 乳腺图像和报告数据体系 |
| 英文关键词:Ultrasonography Mammography Breast diseases Breast imaging reporting and data system |
| 基金项目:上海市科委基金(064119632)。 |
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| 中文摘要: |
| 目的 回顾性分析不同年资超声医师和X线医师运用BI-RADS判断乳腺病灶影像学特征的一致性。 方法 超声图像和钼靶图像各由1名经验丰富的医师采集、存图。参照BI-RADS描述的各影像特征,由不同年资超声和X线医师分别对441个乳腺病灶的影像图独立阅片,记录每个病灶的影像学特征。用Cohens Kappa(K)统计分析不同年资医师判断病灶特征的一致性。 结果 ①两名不同年资X线医师判断乳腺有无病灶的整体一致性好(K=0.71),判断病灶形状、边缘的整体一致性呈中度(K=0.45、0.47),而判断病灶密度的整体一致性弱(K=0.26);判断乳腺有无钙化和钙化形态整体一致性好(K=0.73、0.78);②两名不同年资超声医师判断乳腺病灶形状的整体一致性好(K=0.66),判断病灶有无包膜、内部回声整体一致性呈中度(K=0.57、0.41);而判断病灶边缘、后方回声的整体一致性弱(K=0.35、0.40)。 结论 BI-RADS术语描述病灶特征较为详细,受诊断者经验影响较小。 |
| 英文摘要: |
| Objective To retrospectively evaluate interobserver variability for lesion features on mammogram (MMG) and ultrasonography (US) between junior and senior radiologists using terminology of the breast imaging reporting and data System (BI-RADS). Methods The MMG and US images were obtained by an experienced breast doctor, respectively. Four breast radiologists independently reviewed all the 441 lesions on US and MMG images, respectively. Each observer described each lesion with BI-RADS terminology and recorded lesion features, respectively. Interobserver variability for lesion features on US and MMG were obtained and analyzed with the Cohens statistic. Results ①For MMG descriptors, substantial agreement was obtained for lesion presence or absence (K=0.71), moderate agreement for lesion shape and margin (K=0.45, 0.47, respectively), fair agreement for lesion density (K=0.26). Substantial agreement was obtained for calcification presence or absence and calcification morphology (K=0.73, 0.78, respectively); ②For US descriptors, substantial agreement was obtained for lesion shape, moderate agreement for lesion pseudocapsule and echo patter (K=0.57, 0.41, respectively), Fair agreement lesion margin and posterior acoustic feature (K=0.35, 0.40, respectively). Conclusion Interobserver variability are substantial and moderate for most lesion features on MMG, and moderate for most lesion features on US; thus indicates that BI-RADS descriptors can express the lesion characteristics in details and is less influenced by radiologists experience. |
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