2011, Número 2
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Rev Invest Clin 2011; 63 (2)
Validez y reproducibilidad de la interpretación de la mamografía por radiólogos mexicanos, mediante el sistema BI-RADS
Torres-Mejía G, Villaseñor-Navarro Y, Yunes-Díaz E, Ángeles-Llerenas A, Martínez-Montañez OG, Lazcano-Ponce E
Idioma: Español
Referencias bibliográficas: 57
Paginas: 124-134
Archivo PDF: 141.68 Kb.
RESUMEN
Objetivo. La interpretación mamográfica mediante el sistema
BI-RADS determina que una paciente continúe en el
programa de tamizaje regular o sea canalizada para realizarle
estudios adicionales diagnósticos para cáncer de
mama, de ahí la importancia de su evaluación. Se determinó
la sensibilidad, especificidad y exactitud diagnóstica de
la interpretación mamográfica así como la reproducibilidad
inter- e intra-observador, en una muestra aleatoria de
29 radiólogos de la Secretaría de Salud de México.
Material
y métodos. Se seleccionaron 80 estudios mamográficos
diagnósticos y de tamizaje del Instituto Nacional de
Cancerología de la ciudad de México. Bajo las mismas condiciones,
los radiólogos participantes realizaron dos interpretaciones
mediante el sistema BI-RADS.
Resultados.
La sensibilidad en la primera y segunda medición fue de 72
y 74%, respectivamente, mientras que la especificidad fue de
80% en la primera y de 82% en la segunda. El análisis multivariado
mostró una asociación positiva entre el número de
mamogramas interpretados el año previo, el número de cursos
realizados y el índice de exactitud diagnóstica (β =
0.00002; IC 95% 0.000004, 0.00003; p = 0.02; β = 0.005; IC
95% -0.0004, 0.01; p = 0.07, respectivamente). La reproducibilidad
inter-observador fue baja en ambas mediciones (κ
= 0.24; κ = 0.25, respectivamente). Sin embargo, después
de agrupar las categorías del sistema BI-RADS en dos, la
concordancia se incrementó a 0.46 para ambas mediciones.
La concordancia intra-observador fue buena (κ = 0.67).
Conclusiones. El número de mamogramas leídas el año previo
es una buena medida de la experiencia del radiólogo y se
refleja en la exactitud diagnóstica de la interpretación mamográfica.
Los cursos de actualización también tienen un impacto
positivo en la interpretación.
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