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>Revistas >Revista de Investigación Clínica >Año 2011, No. 2


Torres-Mejía G, Villaseñor-Navarro Y, Yunes-Díaz E, Ángeles-Llerenas A, Martínez-Montañez OG, Lazcano-Ponce E
Validez y reproducibilidad de la interpretación de la mamografía por radiólogos mexicanos, mediante el sistema BI-RADS
Rev Invest Clin 2011; 63 (2)

Idioma: Español
Referencias bibliográficas: 57
Paginas: 124-134
Archivo PDF: 141.68 Kb.


Texto completo




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.


Palabras clave: BI-RADS, Reproducibilidad, Cáncer de mama, Sensibilidad, Especificidad.


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