乳腺病变超声乳腺影像报告和数据系统（BI—RADS）诊断一致性的评估  

Inter-observer variability of Breast Imaging Reporting and Data System （BI-RADS） ultrasound final assessment

作　　者：赖兴建[1] 朱庆莉[1] 姜玉新[1] 刘赫[1] 张璟[1] 游珊珊[1] 戴晴[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声诊断科,北京100730

出　　处：《中华超声影像学杂志》2010年第8期701-704,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：国家自然科学基金青年科学基金资助项目（30900372）

摘　　要：目的 评价不同乳腺超声经验评估者使用超声乳腺影像报告和数据系统（BI-RADS）诊断乳腺超声图像的一致性.方法 12位评估者独立评估30个已获病理诊断的乳腺病变的超声图像,得出诊断分级.计算κ值评估一致性、诊断阳性预测值（PPV）和阴性预测值（NPV）.结果 乳腺超声经验丰富的评估者BI-RADS 3、4、5级κ值分别为0.72、0.28和0.60,3级的NPV为93%,5级的PPV为97%,上述结果均随超声经验的减少而下降.结论 乳腺超声经验丰富的评估者使用BI-RADS可提供准确和一致的诊断,但诊断一致性随乳腺超声经验的减少而下降.Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System（BI-RADS） for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions：16 （53%） malignant and 14 （47%） benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value（PPV） and negative predictive value （NPV） for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.

关 键 词：超声检查 乳腺疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学]