医学
置信区间
单变量
核医学
精确检验
逻辑回归
磁共振成像
多元分析
支化(高分子化学)
多元统计
单变量分析
乳房成像
回顾性队列研究
线性回归
放射科
病理
内科学
乳腺癌
统计
数学
癌症
乳腺摄影术
材料科学
复合材料
作者
Youichi Machida,Mitsuhiro Tozaki,Akiko Shimauchi,Tsuyoshi Yoshida
出处
期刊:Radiology
[Radiological Society of North America]
日期:2015-09-01
卷期号:276 (3): 686-694
被引量:18
标识
DOI:10.1148/radiol.2015141775
摘要
To compare positive predictive values (PPVs) of linearly distributed nonmass enhancement (NME) with linear and branching patterns and to identify imaging characteristics of NME that would enable classification as Breast Imaging Reporting and Data System category 3 lesions.The institutional review board approved this retrospective study and waived the requirement to obtain informed consent. Reports of breast magnetic resonance (MR) examinations (n = 9453) that described NME were reviewed from examinations performed at the study institution from January 2008 to December 2011. NME with linear distribution was allocated to one of two subtypes: linear pattern (arrayed in a line) or branching pattern (with branches). The χ(2) test, Fisher exact test, or Student t test was performed for univariate analyses. Factors that showed a significant association with outcome at univariate analyses were assessed with multivariate analyses by using a logistic regression model. Interobserver agreement of the two subtypes between initial interpretation and the interpretation by two additional radiologists who were blinded to any clinical or pathologic information was evaluated with κ analysis.Within the 156 linearly distributed NME lesions, the PPV of the branching pattern (71 of 95 lesions [75%]; 95% confidence interval [CI]: 66%, 84%) was significantly higher than that of the linear pattern (five of 61 lesions [8%]; 95% CI: 1%, 15%) (P < .0001). The PPV of linear pattern lesions smaller than 1 cm was 0% (0 of 30 lesions; 95% CI: 0%, 0%). At multivariate analysis, branching pattern and NME lesion size of 1 cm or greater were significant predictors of malignancy (P < .0001 [odds ratio: 21.6; 95% CI: 7.5, 62.2] and P = .015 [odds ratio: 5.8; 95% CI: 1.4, 24.0], respectively). Substantial interobserver agreement was obtained for differentiating the two subtypes, with κ values of 0.64 (95% CI: 0.51, 0.76), 0.70 (95% CI: 0.59, 0.82), and 0.64 (95% CI: 0.51, 0.76) between the initial interpreter and reviewer 1, the initial interpreter and reviewer 2, and reviewer 1 and reviewer 2, respectively.The branching pattern was a significantly stronger predictor of malignancy than was the linear pattern. NME lesions with a linear pattern that are smaller than 1 cm can be managed with follow-up.
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