汕头大学医学院学报2026，Vol.39Issue(2)：77-83,7.DOI:10.13401/j.cnki.jsumc.2026.02.003
不同年资医师独立操作BI-RADS联合S-Detect诊断乳腺肿物比较
Comparison of BI-RADS combined with S-Detect for diagnosing breast masses by ultrasound physicians with different seniorities under independent operation
摘要
Abstract
Objective:To compare the diagnostic efficacy of the Breast Imaging Reporting and Data System(BI-RADS)combined with S-Detect for breast masses by ultrasound physicians with different seniorities under independent operation,and to evaluate the value of this technology in narrowing the experience gap among physicians.Methods:A total of 92 solid breast masses from 79 female patients who were scheduled for surgical treatment at the First Affiliated Hospital of Shantou University Medical College from June 2021 to January 2023 were prospectively enrolled.Ultrasonographers with low(2 years),intermediate(5 years),and high(≥10 years)seniority independently performed gray-scale ultrasound scanning and S-Detect analysis.Using pathological diagnosis as the gold standard,the diagnostic efficacy was evaluated by receiver operating characteristic(ROC)curve and net reclassification improvement(NRI),and the diagnostic consistency was assessed by Kappa coefficients.Results:Pathology confirmed 59 benign(64.1％)and 33 malignant(35.9％)masses.The overall consistency of S-Detect results among the three physicians was excellent(Fleiss Kappa=0.822).After combining with S-Detect,the area under the ROC curve(AUC)for low-seniority physicians significantly increased from 0.733 to 0.859(adjusted P<0.05),with an NRI of 37.2％;for intermediate-seniority physicians,the AUC increased from 0.852 to 0.876(adjusted P>0.05),with an NRI of 6.4％;for high-seniority physicians,the AUC decreased from 0.961 to 0.911(adjusted P>0.05),with an NRI of-19.3％(P=0.008).The AUC difference between low-and high-seniority physicians narrowed from 0.228 to 0.052,and the diagnostic consistency improved from moderate(Kappa=0.555)to substantial(Kappa=0.777).Conclusion:BI-RADS combined with S-Detect can improve the diagnostic accuracy of low-seniority physicians and effectively narrow the diagnostic gap among physicians with different seniorities,promoting homogenization of diagnostic performance.However,its added value for high-seniority physicians is limited and may introduce misjudgments;thus,it should be applied in a stratified manner in clinical practice.关键词
乳腺肿物/超声检查/乳腺影像报告和数据系统/S-Detect/人工智能/诊断效能Key words
breast masses/ultrasonography/Breast Imaging Reporting and Data System/S-Detect/artificial intelligence/diagnostic efficacy分类
医药卫生引用本文复制引用
林立坤,廖钰明,祁奇,练燕珊,黄喜锋,王金宏..不同年资医师独立操作BI-RADS联合S-Detect诊断乳腺肿物比较[J].汕头大学医学院学报,2026,39(2):77-83,7.基金项目
广东省医学科研基金(A2024154) （A2024154）
