Dinamik kontrastlı meme MRG ile tip 3 boyanma eğrisi saptanan kitle lezyonlarının retrospektif değerlendirilmesi
Retrospective evaluation of the mass lesions that diagnosed type 3 enhancing curve with dynamic contrast enhancing MRG
Yazar: AYŞE BOLAT ÜÇBİLEK
Danışman: DOÇ. DR. FİGEN BİNOKAY
Çukurova Üniversitesi / Tıp Fakültesi / Radyoloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2010
Konu: Radyoloji ve Nükleer Tıp = Radiology and Nuclear Medicine
Dizin: Dinamik analiz = Dynamic analysis ; Manyetik rezonans görüntüleme = Magnetic resonance imaging ; Meme neoplazmları = Breast neoplasms ; Neoplazmlar = Neoplasms ; Teşhis = Diagnosis ; Teşhis-ayırıcı = Diagnosis-differential

Özet:
Amaç: Meme kanseri kadınlarda en sık görülen kanserlerden biridir. Memekanseri taraması için mamografi temel yöntemidir, ancak spesifisitesi düşüktür. MemeMRG morfolojik ve kontrastlanma özellikleri ile kitlenin tanımlanmasında yükseksensitivite ve spesifisite gösterebilir. Bu çalışmada amacımız, dinamik kontrastlı memeMRG ile tip 3 boyanma eğrisi saptanan kitle lezyonlarının morfolojik özelliklerini vebenign-malign ayırımını değerlendirmektir.Gereç ve Yöntem: Ocak 2005-Kasım 2009 tarihleri arasında dinamik kontrastlımeme MRG yapılıp kontrastlanma özelliği tip 3 olan ve biyopsi yapılan hastalarretrospektif olarak değerlendirildi. Meme MRG incelemeleri standart bilateral memekoili kullanılarak General Electric (signa HDxt) marka 1.5 T MR cihazı ilegerçekleştirildi. Hastalar tanıları, kitlenin hangi memede görüldüğü, kadranı, kitleboyutu, şekil, sınır ve sinyal özelliklerine göre sınıflandırıldı. Çalışmaya neoadjuvankemoterapi alan hastalar dahil edilmedi. Dinamik serilerde zaman-sinyal eğrisi içinkitlenin nekrotik olmayan kısmından en az 3 farklı noktadan alınan ölçümler kullanıldı.

Abstract:
Aim: Breast cancer is one of the most common cancer among women.Mammography is basic method to screening breast cancer, but its spesificity is low.Breast MRG can show high sensitivity and specificity with its morphologic andenhancing features to determine the mass. Our aim is in this study to evaluate themorphologic features of mass lesions that determined type 3 enhancing curve with thedynamic contrast-enhanced MRG and benign-malign differentiation.Material and Method: Between January 2005-November 2009, the patients whowere done dynamic contrast-enhanced MRG and that the enhancing feature was type 3and the patients who were done a biopsy were evaluated as retreospective. Breast MRGobservations were actualized by using standard bileteral breast koil with the GeneralElectric(signa HDxt) 1.5 T MR device. The patients were classified according to theirfeatures of diagnosis, on which breast the mass was seen, dial, the mass dimension,shape, limit and signal. The patients who were getting neoadjuvan chemotherapyweren?t included to the study. In the dynamic serials, for time-signal bent,measurements that were taken from non-necrotic side of the mass at least 3 differentpoints were used.Results: One-hundred and seven patients were enrolled in the study. Mean agewas 44,63 years (±10,1 SD). Twenty-five patients (23,4%) was benign and 82 patients(76.6%) was malign diagnosis. Mean age and mass localization was no statisticallysignificant. When evaluated in terms of dimension, the average diameter of benignmasses was 12,7 mm (±10.5), and the diameter of malign masses was 23,93 mm(±15.47) (p<0.001). In terms of the morphologic shape, both of the groups weredifferent, benign masses were usually elliptic and regular bordered and malign masseswere formless and spiküle bordered (p<0001). Again when the signal features areevaluated 18 of the benign masses(72 %), and only 15 of the malign masses (18,3 %)had homogeneous signal. Again both of the groups were statistically significant.(p<0.001).Conclusion: With the dynamic breast MRG type 3 enhancing curve is notsufficient to make the discrimination of benign-malign. Morphologic features absolutelymust be used with the enhancing curve in the disciriminating diagnosis.Key Words: Dynamic breast MRG, Breast cancer, type 3 enhancing.