目的:我们使用乳腺磁共振成像(MRI)的Kaiser评分(KS)寻找与乳腺病变诊断中的假阴性和假阳性结果相关的因素。
方法:我们回顾性分析了1058例乳腺病变患者,这些患者术前接受了乳腺MRI检查,组织病理学检查结果成功。两名放射科医生根据KS标准评估每个病变,分析临床病理特征及MRI表现。进行多因素回归分析以确定与KS结果假阴性和假阳性相关的因素。
结果:在1058个病变中,恶性859例,良性199例。导管内乳头状瘤的误诊率特别高,炎性病变,和黏液性癌.对于乳腺癌,KS产生821(95.6%)真阳性和38(4.4%)假阴性结果。多因素分析显示病灶大小较小(≤1cm)(OR,3.698;95CI,1.430-9.567;p=0.007),不存在同侧乳腺高血管(OR,3.029;95CI,1.370-6.693;p=0.006),和T2WI上存在高强度(或,2.405;95CI,1.121-5.162;p=0.024)与假阴性乳腺癌结果显着相关。对于良性病变,KS产生141(70.9%)真阴性和58(29.1%)假阳性结果。多因素回归分析显示非肿块强化病变(OR,4.660;95CI,2.018-10.762;p<0.001),中等/高背景实质增强(OR,2.402;95CI,1.180-4.892;p=0.016),以及T2WI上存在高强度(或,2.986;95CI,1.386-6.433;p=0.005)与假阳性KS结果显着相关。
结论:一些临床病理和MRI特征影响KS诊断的准确性。了解这些因素可能有助于正确使用KS并指导替代诊断方法。最终提高乳腺病变评估的诊断准确性。
OBJECTIVE: We sought factors associated with false-negative and false-positive results in the diagnosis of breast lesions using the Kaiser score (KS) on breast magnetic resonance imaging (MRI).
METHODS: We retrospectively analyzed 1058 patients with 1058 breast lesions who underwent preoperative breast MRI with successful histopathologic results. Two radiologists assessed each lesion according to KS criteria, and clinicopathologic features and MRI findings were analyzed. Multivariate regression analysis was conducted to identify factors associated with false-negative and false-positive KS results.
RESULTS: Of the 1058 lesions, 859 were malignant and 199 were benign. Particularly high misdiagnosis rates were observed for intraductal papilloma, inflammatory lesion, and mucinous carcinoma. For breast cancer, KS yielded 821 (95.6 %) true-positive and 38 (4.4 %) false-negative results. Multivariate analysis showed that smaller lesion size (≤1 cm) (OR, 3.698; 95 %CI, 1.430-9.567; p = 0.007), absence of ipsilateral breast hypervascularity (OR, 3.029; 95 %CI, 1.370-6.693; p = 0.006), and presence of hyperintensity on T2WI (OR, 2.405; 95 %CI, 1.121-5.162; p = 0.024) were significantly associated with false-negative breast cancer results. For benign lesions, KS yielded 141 (70.9 %) true-negative and 58 (29.1 %) false-positive results. Multivariate regression analysis revealed that non-mass enhancement lesions (OR, 4.660; 95 %CI, 2.018-10.762; p<0.001), moderate/high background parenchymal enhancement (OR, 2.402; 95 %CI, 1.180-4.892; p = 0.016), and the presence of hyperintensity on T2WI (OR, 2.986; 95 %CI, 1.386-6.433; p = 0.005) were significantly associated with false-positive KS results.
CONCLUSIONS: Several clinicopathologic and MRI features influence the accuracy of KS diagnosis. Understanding these factors may facilitate appropriate use of KS and guide alternative diagnostic approaches, ultimately improving diagnostic accuracy in the evaluation of breast lesions.