目的:构建乳腺肿块的综合乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)预测模型,得到不同于单一影像的BI-RADS分类。方法:回顾并分析2019年8月—2020年9月术前行超声、乳腺X线摄影及磁共振成像(magnetic ...目的:构建乳腺肿块的综合乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)预测模型,得到不同于单一影像的BI-RADS分类。方法:回顾并分析2019年8月—2020年9月术前行超声、乳腺X线摄影及磁共振成像(magnetic resonance imaging,MRI)检查的患者图像,根据BI-RADS词典对肿块特征进行评估,取3种影像的最高BI-RADS类别为因变量,影像学特征及临床指征为自变量,根据多元logistic回归构建综合BI-RADS预测模型。结果:综合BI-RADS预测模型分类的阳性预测值(positive predictive value,PPV)在指南的参考范围内[3类(0.00%),4A类(9.61%),4B类(42.41%),4C类(88.18%),5类(97.19%)],模型的受试者工作特征(receiver operating characteristic)曲线的曲线下面积(area under curve,AUC)为0.955。结论:将3种影像的BI-RADS词典联合肿块临床特征得到综合的BI-RADS模型是可行的,极大限度避免漏诊的发生。展开更多
Background The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy. We aimed to assess the value of the computed tomography （CT） and clinical finding...Background The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy. We aimed to assess the value of the computed tomography （CT） and clinical findings in predicting smear- negative pulmonary tuberculosis in AIDS patients. Methods A total of 121 AIDS patients suspected of smear-negative pulmonary tuberculosis by clinical and radiographic findings were recruited. Pulmonary tuberculosis was diagnosed in 57 （47.1%） patients. The CT and clinical predictors were selected to diagnose AIDS-related pulmonary tuberculosis through univariate and multivariate Logistic analysis. Results Multivariate analysis showed that five variables, including weight loss, presence of miliary nodules, necrotic lymph node, Iobular consolidation, tree-in-bud sign, were independent predictors of pulmonary tuberculosis in AIDS patients. Predicted scores based on the five variables were used to identify pulmonary tuberculosis. If the predicted score of 3 was taken as the ideal cut-off point in the diagnosis of AIDS-related smear-negative pulmonary tuberculosis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.2%, 81.2%, 80.0%, 85.2%, and 82.6%, respectively. Conclusion The prediction method based on five key factors of clinical and CT findings are useful in guiding the diagnosis of smear-negative pulmonary tuberculosis in AIDS patients.展开更多
文摘目的:构建乳腺肿块的综合乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)预测模型,得到不同于单一影像的BI-RADS分类。方法:回顾并分析2019年8月—2020年9月术前行超声、乳腺X线摄影及磁共振成像(magnetic resonance imaging,MRI)检查的患者图像,根据BI-RADS词典对肿块特征进行评估,取3种影像的最高BI-RADS类别为因变量,影像学特征及临床指征为自变量,根据多元logistic回归构建综合BI-RADS预测模型。结果:综合BI-RADS预测模型分类的阳性预测值(positive predictive value,PPV)在指南的参考范围内[3类(0.00%),4A类(9.61%),4B类(42.41%),4C类(88.18%),5类(97.19%)],模型的受试者工作特征(receiver operating characteristic)曲线的曲线下面积(area under curve,AUC)为0.955。结论:将3种影像的BI-RADS词典联合肿块临床特征得到综合的BI-RADS模型是可行的,极大限度避免漏诊的发生。
文摘Background The correct diagnosis of sputum smear-negative pulmonary tuberculosis in AIDS patients is very important to their therapy. We aimed to assess the value of the computed tomography （CT） and clinical findings in predicting smear- negative pulmonary tuberculosis in AIDS patients. Methods A total of 121 AIDS patients suspected of smear-negative pulmonary tuberculosis by clinical and radiographic findings were recruited. Pulmonary tuberculosis was diagnosed in 57 （47.1%） patients. The CT and clinical predictors were selected to diagnose AIDS-related pulmonary tuberculosis through univariate and multivariate Logistic analysis. Results Multivariate analysis showed that five variables, including weight loss, presence of miliary nodules, necrotic lymph node, Iobular consolidation, tree-in-bud sign, were independent predictors of pulmonary tuberculosis in AIDS patients. Predicted scores based on the five variables were used to identify pulmonary tuberculosis. If the predicted score of 3 was taken as the ideal cut-off point in the diagnosis of AIDS-related smear-negative pulmonary tuberculosis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.2%, 81.2%, 80.0%, 85.2%, and 82.6%, respectively. Conclusion The prediction method based on five key factors of clinical and CT findings are useful in guiding the diagnosis of smear-negative pulmonary tuberculosis in AIDS patients.
