The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
Emerg Radiol. 2022 Dec;29(6):987-993. doi: 10.1007/s10140-022-02081-x. Epub 2022 Aug 16.
Pediatric patients with breast-related symptoms often initially present to the emergency department for evaluation. While pediatric radiologists are accustomed to evaluating acute infectious and traumatic etiologies, they may be less familiar with breast-specific findings. This study compares management recommendations of pediatric breast ultrasounds performed in the emergency setting between pediatric and breast imaging radiologists.
This retrospective cohort study reviewed data from all pediatric breast ultrasounds performed in the emergency setting from a single academic institution from 1/1/14 to 12/31/19. During the study period, 12 pediatric radiologists with experience ranging from 1 to 33 years interpreted pediatric breast ultrasounds. Three breast imaging radiologists (with 3, 8, and 25 years of experience) retrospectively reviewed each case and recorded whether further management was recommended. Differences in recommendations were compared using Fisher's exact test. Cohen's kappa was used to assess agreement between subspecialty radiologists.
This study included 75 pediatric patients, with mean age 13 ± 5.6 years and malignancy rate of 1.3% (1/75). Pediatric radiologists and the most experienced breast imaging radiologist had moderate agreement in management recommendations (k = 0.54). There was no significant difference in recommendations for further management between pediatric radiologists (22/75 [29.3%]) and the most experienced breast imaging radiologist (15/75 [20.0%]), p = 0.26.
Recommendations for pediatric breast complaints in the emergency setting are comparable between subspecialties.
儿科患者常因乳房相关症状而首先到急诊科就诊进行评估。儿科放射科医生虽然习惯于评估急性感染和创伤性病因，但他们可能对乳房特异性表现不太熟悉。本研究比较了在急诊科进行的儿科乳房超声检查的管理建议，比较了儿科放射科医生和乳腺影像放射科医生的管理建议。
本回顾性队列研究回顾了 2014 年 1 月 1 日至 2019 年 12 月 31 日期间，在一家学术机构的急诊科进行的所有儿科乳房超声检查的数据。在研究期间，12 名具有 1 至 33 年经验的儿科放射科医生对儿科乳房超声进行了检查。三名乳腺影像放射科医生（具有 3、8 和 25 年的经验）回顾了每个病例，并记录了是否推荐进一步治疗。使用 Fisher 精确检验比较建议的差异。使用 Cohen's kappa 评估亚专科放射科医生之间的一致性。
本研究共纳入 75 名儿科患者，平均年龄 13 ± 5.6 岁，恶性肿瘤发生率为 1.3%（1/75）。儿科放射科医生和最有经验的乳腺影像放射科医生在管理建议上有中度一致性（k = 0.54）。儿科放射科医生（22/75 [29.3%]）和最有经验的乳腺影像放射科医生（15/75 [20.0%]）之间，进一步管理的建议无显著差异，p = 0.26。
在急诊科，儿科乳房投诉的处理建议在各专业之间是可比的。
