目的 探讨医师学习并掌握超声乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)所需要的最少病例数,为使用BI-RADS进行临床教学提供参考。 方法 对2017年10月至2018年10月在北京大学第三医院参加住院医师规范化培训(以下简称“住培”)的第一年8名住培医师、第二年10名住培医师和10名进修医师进行BI-RADS培训。培训后,将100个乳腺病例随机分成5组,每组20个病例,分5次对医师进行考核。考核以主任医师读图结果为标准,通过对比每次医师读图的正确与否计算评分,绘制3类医师的学习曲线并进行分析。 结果 3类医师BI-RADS学习曲线从第二次考核评分开始明显升高,而第二次至第五次考核评分走势较为平稳。第一年住培医师、第二年住培医师、进修医师各组自身的前2次考核评分之间的差异均具有统计学意义[(28.8±16.9)分比(50.0±9.3)分,(31.5±7.5)分比(53.5±6.7)分,(50.5±8.0)分比(62.0±13.4)分,均P＜0.05]。 结论 住培医师和进修医师经过理论培训和40例病例的读片培训后即可以基本掌握BI-RADS。

Objective To investigate the minimal and essential practice for learning breast imaging reporting and data system (BI-RADS ) for ultrasound, investigate the regular pattern of its learning, so as to provide reference for clinical training and evaluation. Methods Eight first-year residents, ten second-year residents and ten refresher doctors were trained for BI-RADS for ultrasound using the non-randomized experimental studies from October 2017 to October 2018. One hundred breast tumors were randomly divided into 5 groups with 20 cases in each group. Scores were compared among the 5 groups according to the results of chief physicians and the learning curve of was analyzed. Results The learning curve for the three categories of physicians increased significantly from the second time, while the trend of the second time to the fifth time was relatively stable. There were statistically significant differences in the diagnostic scores between the first time and second time for first-year residents, second-year residents and refresher doctors [(28.8±16.9) vs (50.0±9.3), (31.5±7.5) vs (53.5±6.7), (50.5±8.0) vs (62.0±13.4); all P＜0.05]. Conclusions Residents and refresher physicians may master the BI-RADS dictionary after the theoretical training of BI-RADS dictionary and the reading training of about 40 cases.