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乳腺动脉钙化:报告偏好及其对冠状动脉疾病筛查的影响

Breast Arterial Calcifications: Reporting Preferences and Impact on Screening for Coronary Artery Disease.

作者信息

Zaki-Metias Kaitlin M, MacLean Jeffrey J, Mergo Paul A, Ogunde Barakat, Al-Hameed Mohammed, Trivax Cory Z

机构信息

St. Joseph Mercy Oakland Hospital, Department of Radiology, Pontiac, MI, USA.

Huron Valley Radiology, Ypsilanti, MI, USA.

出版信息

J Breast Imaging. 2021 Nov 16;3(6):687-693. doi: 10.1093/jbi/wbab076.

Abstract

OBJECTIVE

Breast arterial calcifications (BAC) have been shown to correlate with measures of coronary artery disease risk stratification, although reporting of BAC is optional by BI-RADS guidelines. The purpose of this study is to determine referring provider preferences in BAC reporting on mammography reports and if such reporting has any impact on patient management.

METHODS

This study was approved by the local institutional review board. A voluntary eight-question survey regarding the preferences and outcomes of BAC reporting on mammography was distributed to 1085 primary care physicians, obstetrics and gynecologists, medical oncologists, and breast and general surgeons in our health system via a secure online platform. Data analysis including Pearson chi-square was performed with a P-value of <0.05 for significance.

RESULTS

A response rate of 19.1% (207/1085) was attained, with 21/207 (10.1%) of respondents indicating they do not routinely order mammograms excluded from further analysis. A total of 62.4% (116/186) of ordering physicians indicated a preference for reporting of BAC in both the body and impression of the radiology report, with 82.3% (153/186) of respondents placing importance on the quantity of atherosclerotic calcifications. Most participants (148/186, 79.6%) reported that the presence of BAC would prompt further investigation for coronary artery disease and associated risk factors.

CONCLUSION

The majority of responding physicians indicated a preference for detailed reporting of BAC and that such reporting would impact patient care. Understanding referring provider preferences regarding ancillary findings of BAC will allow for improved communication and value in mammography.

摘要

目的

乳腺动脉钙化(BAC)已被证明与冠状动脉疾病风险分层指标相关,尽管BI-RADS指南并未强制要求报告BAC。本研究的目的是确定转诊医生在乳腺钼靶报告中对BAC报告的偏好,以及这种报告是否会对患者管理产生任何影响。

方法

本研究经当地机构审查委员会批准。通过安全的在线平台,向我们医疗系统中的1085名初级保健医生、妇产科医生、医学肿瘤学家以及乳腺外科和普通外科医生发放了一份关于乳腺钼靶检查中BAC报告偏好和结果的自愿性八问题调查问卷。进行包括Pearson卡方检验在内的数据分析,P值<0.05具有统计学意义。

结果

回复率为19.1%(207/1085),其中21/207(10.1%)的受访者表示他们不常规开具乳腺钼靶检查,这些受访者被排除在进一步分析之外。共有62.4%(116/186)的开具检查的医生表示倾向于在放射学报告的正文和印象中都报告BAC,82.3%(153/186)的受访者认为动脉粥样硬化钙化的数量很重要。大多数参与者(148/186,79.6%)报告称,BAC的存在会促使对冠状动脉疾病及相关风险因素进行进一步调查。

结论

大多数回复的医生表示倾向于详细报告BAC,并且这种报告将影响患者护理。了解转诊医生对BAC辅助检查结果的偏好将有助于改善乳腺钼靶检查中的沟通并提高其价值。

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