Meme kitlelerinin ayırıcı tanısında elastografinin tanıya katkısının değerlendirilmesi ve histopatolojik korelasyonu
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Meme kanserinin tarama ve tanısında günümüzde altın standart olarak MG (mamografi) ve USG (ultrason görüntüleme) birlikte kullanılmaktadır. Ancak erken tanıda istenilen düzeye ulaşılamamış ve gereksiz biyopsi işlemlerinin önüne geçilemiştir. Çalışmamızda elastografi tekniklerinin meme lezyonların benign- malign ayırımında etkinliğinin araştırılması amaçlanmıştır. Metod: Çalışmamıza B-mod USG ile BIRADS skorlamasına göre biyopsi endikasyonu konan 58 hasta dahil edildi. Meme lezyonlarına strain elastografi tekniğiyle cihaz tarafından belirlenen, yeterli seviyede kompresyon uygulandıktan sonra lezyonların E-index ölçümleri yapıldı. Elastografi kutusundaki normal meme dokusunun sertlik derecesinin lezyonunkine oranı olan strain-ratio ölçümleri yapıldı. Shear-wave tekniğiyle lezyonların sınırı içinde sertlik derecesini gösteren renk haritalaması yapıldı. Renk haritalamaya göre lezyonun en sert odağından shearwave hız ölçümleri yapıldı. Elde edilen ölçümler lezyonların biyopsi sonuçları referans alınarak prospektif olarak değerlendirildi. Bulgular: Tamamı kadın olan 58 hastanın yaş ortalaması 46,9±11, 58 lezyonun ortalama boyutu 29,4±12,7 olarak hesaplandı. Strain elastografi tekniğinde belirlenen E-index değerlerin ortalaması malign lezyonlarda 3,9, benign lezyonlarda 2,1ve E-ratio değerlerin ortalaması malign lezyonlarda 5,0±2,6 , benign lezyonlarda 1,6 olarak ölçülmüştür. Lezyonların shearwave (m/sn) hızlarının ortalama değerleri malign lezyonlarda 6,3±1,3, benign lezyonlarda 4,3 olarak ölçülmüştür. Malign grubun E-index, E-ratio ve shearwave (m/sn) ortancası, benign grubuna göre anlamlı derecede yüksek çıkmıştır. Sonuç: SE (sonoelastografi) tekniklerinin meme lezyonlarının benign-malign ayrımında oldukça başarılı ve tanısal değerlerinin yüksek olduğu bulunmuştur. SE, günümüzde meme kanserinin tarama ve tanısında rutin olarak uygulanan B-Mod US ve MG tetkikleriyle birlikte pratik olarak uygulanılabilmektedir. SE tekniklerin meme lezyonlar için yapılması planlanan, günümüzde altın standart yöntem kabul edilen biyopsi ihtiyacını gelecekte azaltabileceğini düşünmekteyiz.
Purpose: MG (mammography) and US (ultrasonography) are primarily used in the screening and diagnosis of breast cancer in woman. However, mammography and ultrasonography have not sufficient yet during early diagnosis in breast cancer and preventing the unnecessary biopsy procedures. In our study, it was aimed to investigate the efficacy of elastography techniques in the benign-malignant differentiation of breast lesions. Methods: Fiftyeight patients with biopsy indication according to BIRADS score, participated in our study. E-index measurements of the breast lesions were performed after compression compression's level is determined by device using the technique of strain elastography. Strain-ratio measurements, which are the ratio of normal breast tissue and elasticity of lesions were performed. Color mapping was performed with shear-wave technique that shows the degree of elasticity within the lesion's border. Shearwave velocity measurements were made from the hardest point of the lesion according to color mapping. Obtained measurements were evaluated prospectively with reference to biopsy results of the lesions. Findings: The mean age of 58 patients was 46.9±11, and the mean size of 58 lesions was 29.4±12.7. The mean E-index values were 3.9 for malignant lesions, 2.1 for benign lesions and the mean E-ratio values were 5,0 ± 2,6 for malign lesions, 1,6 for benign lesions in strain elastography techniques. The mean values of the shearwave (m/sec) velocities of the lesions were measured as 6,3±1,3 in malign lesions and 4.3 in benign lesions. E-index, E-ratio and shearwave speed parameters of the malignant group were significantly higher than the benign group. Conclusion: SE (sonoelastography) techniques are very successful to distinguish malign lesions from benign lesions and the techniques have high diagnostic value in breast cancer. SE can be practically applied routinely with B-Mode US and MG tests in screening and diagnosis of breast cancer. We think that SE techniques may reduce the need for biopsy in the future, which is still considered the gold standard method for breast lesions.
Purpose: MG (mammography) and US (ultrasonography) are primarily used in the screening and diagnosis of breast cancer in woman. However, mammography and ultrasonography have not sufficient yet during early diagnosis in breast cancer and preventing the unnecessary biopsy procedures. In our study, it was aimed to investigate the efficacy of elastography techniques in the benign-malignant differentiation of breast lesions. Methods: Fiftyeight patients with biopsy indication according to BIRADS score, participated in our study. E-index measurements of the breast lesions were performed after compression compression's level is determined by device using the technique of strain elastography. Strain-ratio measurements, which are the ratio of normal breast tissue and elasticity of lesions were performed. Color mapping was performed with shear-wave technique that shows the degree of elasticity within the lesion's border. Shearwave velocity measurements were made from the hardest point of the lesion according to color mapping. Obtained measurements were evaluated prospectively with reference to biopsy results of the lesions. Findings: The mean age of 58 patients was 46.9±11, and the mean size of 58 lesions was 29.4±12.7. The mean E-index values were 3.9 for malignant lesions, 2.1 for benign lesions and the mean E-ratio values were 5,0 ± 2,6 for malign lesions, 1,6 for benign lesions in strain elastography techniques. The mean values of the shearwave (m/sec) velocities of the lesions were measured as 6,3±1,3 in malign lesions and 4.3 in benign lesions. E-index, E-ratio and shearwave speed parameters of the malignant group were significantly higher than the benign group. Conclusion: SE (sonoelastography) techniques are very successful to distinguish malign lesions from benign lesions and the techniques have high diagnostic value in breast cancer. SE can be practically applied routinely with B-Mode US and MG tests in screening and diagnosis of breast cancer. We think that SE techniques may reduce the need for biopsy in the future, which is still considered the gold standard method for breast lesions.
Açıklama
YÖK Tez No: 489981
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine, Elastografi, Elastography, Histopatoloji, Histopathology, Meme hastalıkları, Breast diseases, Meme neoplazmları, Breast neoplasms, Neoplazmlar, Neoplasms, Teşhis, Diagnosis, Teşhis-ayırıcı, Diagnosis-differential, Ultrasonografi, Ultrasonography, Sonoelastografi, meme lezyonları, strain ratio, shearwave, Sonoelastography, breast lesions, strain ratio, shear wave