Mamografide tek projeksiyonda görülen fokal asimetrik opasitelerin meme MRG ile değerlendirilmesi
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Date
2016
Authors
Pektaş, Fatih
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Meme kanseri kadınlarda en sık görülen invaziv kanser türüdür. Meme kanseri taramasında ve meme lezyonlarının değerlendirilmesinde mamografi temel görüntüleme yöntemidir ancak mamografi ile her zaman kesin sonuca varılamamaktadır. Mamografi ile tanı konulamayan olgularda ultrasonografi (US) ve manyetik rezonans görüntüleme (MRG) yardımcı görüntüleme yöntemleridir. Bu çalışmamızın amacı; mamografide tek projeksiyonda fokal asimetrik opasite görülen olgularda meme MRG bulgularının ve meme MRG'nin tanıya katkısının değerlendirilmesidir. Retrospektif olarak planlanan bu çalışmaya Eylül 2014–Kasım 2015 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Radyoloji A.D.'nda yapılan mamografilerinde tek projeksiyonda fokal asimetrik opasite görülmüş ve daha sonra sorun çözücü olarak meme MRG yapılmış 55 kadın hastaya ait toplam 60 asimetrik opasite dahil edildi. Olguların MRG görüntüleri American Collage of Radiology (ACR) Breast Imaging Reporting and Data Systems (BIRADS) MRG kriterlerine göre değerlendirildi. Olguların %61,6'i asimetrik fibroglandüler doku (BIRADS 1), %25'i benign (BIRADS 2), %11,6'sı malignite kuşkulu (BIRADS 4) ve %1,6'sı malign olma olasılığı yüksek (BIRADS 5) olarak değerlendirildi. MRG'de BIRADS 4 ve 5 olarak değerlendirilen olgulardan 4'ü (%6,6) malign olarak teyit edildi. MRG'nin sensitivitesi, spesifitesi, pozitif ve negatif öngörü değerleri sırasıyla %100, %94,5, %57,1 ve %100 olarak bulundu. Sonuç olarak tek projeksiyonda görülen fokal asimetrik opasiteler sıklıkla asimetrik fibroglandüler dokulardan kaynaklanmaktadır ancak benign ve malign patolojiler de tek projeksiyonda görülen fokal asimetrik opasiteye neden olabilmektedir. Yoğun meme parankimi, aksiller kuyruk, göğüs duvarı ve sternuma yakın yerleşim, operasyon skarı ve anatomik varyasyonlar gibi diğer görüntüleme yöntemlerinin yetersiz kaldığı durumlarda ve multifokal, multisentrik meme kanserlerinde meme MRG tanıya katkı sağlamaktadır.
Breast cancer is the most common invasive cancer in women. Mammography is the primary imaging modality for detection of breast cancer and evaluation of breast lesions but mammography sometimes yield equivocal results despite a thorough diagnostic evaluation. Ultrasonography (US) and magnetic resonance imaging (MRI) are adjunctive imaging modalities when mammographic findings are inconclusive. The aim of this study was to evaluate the findings and the usefulness of breast MRI in cases of focal asymmetric opacities seen on only one mammographic view. Sixty asymmetric opacities of 55 female patients in whom MRI was performed for problem solving for focal asymmetric opacities seen on one mammographic view between September 2014 and November 2015 were included in this retrospective study. MRI images of patients were evaluated according to American College of Radiology (ACR) Breast Imaging Reporting and Data Systems (BIRADS) MRI criteria. 61,6% of cases were evaluated as asymmetric fibroglanduler tissue (BIRADS 1), 25% of cases were evaluated as benign (BIRADS 2), 11,6% of cases were evaluated as suspicious for malignancy (BIRADS 4) and 1,6% of cases were evaluated as highly suggestive of malignancy (BIRADS 5). In BIRADS 4 and 5 cases, 4 (6,6%) malignant lesions were histopathologically verified. MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 94.5%, 57.1% and 100% respectively. As a result focal asymmetric opacities seen on only one mammographic view were most frequently originate from normal fibroglandular tissue, but benign and malignant pathologies can also cause focal asymmetric opacities seen on only one mammographic view. Breast MRI is an adjunctive modality when conventional imaging methods were inadequate due to dens breast parenchyma, surgical scars, anatomic variations, lesions located closer to chest wall, sternum and axillary tail and for the diagnosis of multifocal, multicentric breast cancer.
Breast cancer is the most common invasive cancer in women. Mammography is the primary imaging modality for detection of breast cancer and evaluation of breast lesions but mammography sometimes yield equivocal results despite a thorough diagnostic evaluation. Ultrasonography (US) and magnetic resonance imaging (MRI) are adjunctive imaging modalities when mammographic findings are inconclusive. The aim of this study was to evaluate the findings and the usefulness of breast MRI in cases of focal asymmetric opacities seen on only one mammographic view. Sixty asymmetric opacities of 55 female patients in whom MRI was performed for problem solving for focal asymmetric opacities seen on one mammographic view between September 2014 and November 2015 were included in this retrospective study. MRI images of patients were evaluated according to American College of Radiology (ACR) Breast Imaging Reporting and Data Systems (BIRADS) MRI criteria. 61,6% of cases were evaluated as asymmetric fibroglanduler tissue (BIRADS 1), 25% of cases were evaluated as benign (BIRADS 2), 11,6% of cases were evaluated as suspicious for malignancy (BIRADS 4) and 1,6% of cases were evaluated as highly suggestive of malignancy (BIRADS 5). In BIRADS 4 and 5 cases, 4 (6,6%) malignant lesions were histopathologically verified. MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 94.5%, 57.1% and 100% respectively. As a result focal asymmetric opacities seen on only one mammographic view were most frequently originate from normal fibroglandular tissue, but benign and malignant pathologies can also cause focal asymmetric opacities seen on only one mammographic view. Breast MRI is an adjunctive modality when conventional imaging methods were inadequate due to dens breast parenchyma, surgical scars, anatomic variations, lesions located closer to chest wall, sternum and axillary tail and for the diagnosis of multifocal, multicentric breast cancer.
Description
Keywords
Fokal asimetrik opasite, Mamografi, Meme MRG, Tek projeksiyon, Breast MRI, Focal asymmetric opacity, Mammography, One view
Citation
Pektaş, F. (2016). Mamografide tek projeksiyonda görülen fokal asimetrik opasitelerin meme MRG ile değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.