比较三位读者使用 BI-RADS 和基于肿块和非肿块增强 (NME) 病灶的 Kaiser 评分 (KS) 的诊断性能。共检查了 630 个病灶，其中 393 个恶性和 237 个良性，458 个肿块和 172 个 NME。分析了。三位具有3年、6年和13年经验的放射科医生做出了诊断。 596例进行弥散加权成像，并测量表观弥散系数（ADC）。对于ADC > 1.4 × 10-3 mm2/s的病灶，将KS降低4作为修正后的KS ，并评估获益。使用BI-RADS时，肿块的AUC分别为0.878、0.915和0.941，肿块的AUC为0.771 Reader-1、2 和 3 的 NME 分别为 0.838、0.902，质量比 NME 更好。对于经验不足的读者来说，KS 的诊断准确性比 BI-RADS 有所提高。对于 Reader-1，质量 AUC 从 0.878 增加到 0.916 (p = 0.005)，NME 从 0.771 增加到 0.822 (p = 0.124)。根据 BI-RADS ≥ 4B 和 KS ≥ 5 为恶性的临界值，Readers-1 和 -2 的 KS 对于 Mass 和 NME 的敏感性显着较高。当 ADC 被考虑改为改进的 KS  时，所有三个读者的 AUC 和准确性均得到改善，显示出更高的特异性，但灵敏度略有下降。与 BI-RADS 相比，KS 的优势对于经验不足的读者在提高灵敏度方面最为明显。与 KS 相比，KS  可以提高所有三种读者的特异性。对于NME，KS和KS 标准有待进一步完善。KS为乳腺MRI诊断病变提供了直观的方法。与肿块病变相比，BI-RADS 和 KS 在评估 NME 时面临更大的困难。在 KS 中添加 ADC 可以提高特异性，但敏感性略有下降。KS 提供了一种直观的方法来解释 MRI 上的乳腺病变，对新手读者最有帮助。与 BI-RADS 相比，KS 对于经验不足的读者提高了大众和 NME 组的灵敏度。在 KS 流程图的开发过程中考虑了 NME 病变，但可能需要更好地定义。© 2024。作者，获得欧洲放射学会的独家许可。

To compare the diagnostic performance of three readers using BI-RADS and Kaiser score (KS) based on mass and non-mass enhancement (NME) lesions.A total of 630 lesions, 393 malignant and 237 benign, 458 mass and 172 NME, were analyzed. Three radiologists with 3 years, 6 years, and 13 years of experience made diagnoses. 596 cases had diffusion-weighted imaging, and the apparent diffusion coefficient (ADC) was measured. For lesions with ADC > 1.4 × 10-3 mm2/s, the KS was reduced by 4 as the modified KS +, and the benefit was assessed.When using BI-RADS, AUC was 0.878, 0.915, and 0.941 for mass, and 0.771, 0.838, 0.902 for NME for Reader-1, 2, and 3, respectively, better for mass than for NME. The diagnostic accuracy of KS was improved compared to BI-RADS for less experienced readers. For Reader-1, AUC was increased from 0.878 to 0.916 for mass (p = 0.005) and from 0.771 to 0.822 for NME (p = 0.124). Based on the cut-off value of BI-RADS ≥ 4B and KS ≥ 5 as malignant, the sensitivity of KS by Readers-1 and -2 was significantly higher for both Mass and NME. When ADC was considered to change to modified KS +, the AUC and the accuracy for all three readers were improved, showing higher specificity with slightly degraded sensitivity.The benefit of KS compared to BI-RADS was most noticeable for the less experienced readers in improving sensitivity. Compared to KS, KS + can improve specificity for all three readers. For NME, the KS and KS + criteria need to be further improved.KS provides an intuitive method for diagnosing lesions on breast MRI. BI-RADS and KS face greater difficulties in evaluating NME compared to mass lesions. Adding ADC to the KS can improve specificity with slightly degraded sensitivity.KS provides an intuitive method for interpreting breast lesions on MRI, most helpful for novice readers. KS, compared to BI-RADS, improved sensitivity in both mass and NME groups for less experienced readers. NME lesions were considered during the development of the KS flowchart, but may need to be better defined.© 2024. The Author(s), under exclusive licence to European Society of Radiology.