Kaiser评分对乳腺超声BI-RADS 4A病变的诊断价值和避免不必要活检的潜力  

Diagnostic value of the Kaiser score for US BI-RADS 4A lesions of breast andpotential to avoid unnecessary biopsies

作　　者：郭转转 张冰[1] 雷喆[1] 梁文斌 杨全新[1] 陈欣[1] GUO Zhuanzhuan;ZHANG Bing;LEI Zhe;LIANG Wenbin;YANG Quanxin;CHEN Xin(Department of Radiology,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院影像科,陕西西安710004

出　　处：《西安交通大学学报(医学版)》2025年第2期304-309,共6页Journal of Xi’an Jiaotong University(Medical Sciences)

基　　金：陕西省卫生健康高层次人才培育计划项目。

摘　　要：目的评估Kaiser评分对乳腺超声(US)BI-RADS 4A病变的诊断效能和避免不必要活检的潜力。方法回顾性收集2019年5月—2023年6月间行乳腺US及磁共振成像(MRI)检查的患者资料,所有病例均经穿刺活检或手术病理证实。以病理结果为金标准,计算并比较Kaiser评分及MRI BI-RADS分类对US BI-RADS 4A病变的诊断效能。结果119例患者共119个病变(良性病变74个,恶性病变45个)。Kaiser评分的诊断效能显著优于MRI BI-RADS分类(AUC:0.88 vs.0.65,P<0.0001)。Kaiser评分结果与病理结果的一致性及观察者间一致性均优于MRI BI-RADS分类。应用Kaiser评分和MRI BI-RADS分类诊断US BI-RADS 4A病变时可分别避免87.8%(65/74)、33.8%(25/74)的不必要活检。结论Kaiser评分可以为US BI-RADS 4A类病变的风险分层提供诊断依据,其诊断效能及观察者间一致性均优于MRI BI-RADS分类。Objective To evaluate the diagnostic efficacy of the Kaiser score for ultrasound(US)BI-RADS 4A lesions and the potential to avoid unnecessary biopsies.Methods Data of patients who underwent breast US and magnetic resonance imaging(MRI)between May 2019 and June 2023 were retrospectively collected,and all cases were confirmed by puncture biopsy or surgical pathology.The diagnostic efficacy of Kaiser score and MRI BI-RADS classification for US BI-RADS 4A lesions was calculated and compared using pathologic findings as the gold standard.Results A total of 119 lesions(74 benign and 45 malignant lesions)were found in the 119 patients.The diagnostic efficacy of the Kaiser score was significantly better than that of the MRI BI-RADS classification(AUC:0.88 vs.0.65,P<0.0001).The concordance of the Kaiser score results with the pathologic findings and the inter-observer concordance were better than that of the MRI BI-RADS classification.Unnecessary biopsies could be avoided in 87.8%(65/74)and 33.8%(25/74)of the cases when the Kaiser score and the MRI BI-RADS classification were applied for the diagnosis of US BI-RADS 4A lesions,respectively.Conclusion The Kaiser score can provide a diagnostic basis for risk stratification of US BI-RADS 4A lesions,and its diagnostic efficacy and inter-observer agreement are superior to those of MRI BI-RADS classification.

关 键 词：乳腺病变 超声(US) 磁共振成像(MRI) Kaiser评分 乳腺数据与报告系统 

分 类 号：R445.2[医药卫生—影像医学与核医学]