Publication: Meme kitlelerinin ayırıcı tanısında elastografinin tanıya katkısının değerlendirilmesi ve histopatolojik korelasyonu
Abstract
Amaç: Referans standart olarak patolojik tanı kullanılarak solid meme kitlelerinin malign ve benign ayrımında ultrasonografik (US) elastografinin sensitivitesini ve spesifitesini prospektif olarak değerlendirmektir. Metod: Memede saptanan lezyona yönelik perkütan biyopsi için Marmara Üniversitesi Radyodiagnostik Bölümüne başvuran 96 hasta çalışmaya alındı. Hastalarda saptanan 110 lezyona konvansiyonel US ve gerçek zamanlı elastografi tekniği uygulanarak görüntüler prospektif olarak değerlendirildi. Ultrason elastografisindeki doku sertliği ,kompresyon kaldırılırkenki elastisite derecelerine göre 1’den (tüm lezyon üzerindeki en düşük sertlik) 4’e (tüm lezyon üzerindeki ve doku çevresindeki en yüksek sertlik) kadar görsel olarak derecelendirildi. Bulgular: US elastografi değerlendirmesinde; Elastogarfi skorları 1 ve 2 olanlar benign ,3 ve 4 olanlar malign olarak kabul edildiğinde (p<0,001); duyarlılığı %83, özgüllüğü %89, pozitif prediktif değeri %79 ve negatif prediktif değeri %91 bulundu. Histopatolojik olarak benign 73 lezyonun 65’i (%89) skor 1 ve 2 iken ,8 ‘i (%11) skor 3 ve 4 idi. Histopatoloji sonucu malign olarak gelen 37 nodülün 31’i (%84) skor 3 ve 4 iken 6’sı (%16) skor 2 olarak değerlendirildi. Sonuçlar: Meme lezyonlarının tanısında ultrasonografik elastografinin yüksek duyarlılığa ve özgüllüğe sahip olduğu belirlendi. Elastografi yöntemi ultrasonografi ile birleştirilerek memenin malign ve benign lezyonlarının ayırt edilmesinde kullanılabilir. Anahtar Kelime : Elastografi, US elastografi görüntülemesi, meme,
Purpose: To prospectively evaluate the sensitivity and specificity of ultrasonographic (US) elastography for distinguishing between benign and malignant solid breast masses, with pathologic results as the reference standard. Methodology: Breast lesion identified 96 patients admitted to the Department of Marmara University Radiodiagnostik for percutaneous biopsy in the study. Hundred and ten lesions in patients evaluated prospectively with conventional US and real-time elastography technique. Tissue hardness observed in the ultrasound elastography was visually scaled according to the degree of compression is removed from 1 (low degree firmness on entire nodule) to 4 (high degree firmness on entire nodule and peripheral tissue). Findings: The US elastography evaluation; 83% sensitivity, 89% specifity, 79% positive predictive value and 91% negative predictive value assuming that tumour imaging scores of 3 and 4 are malign and tumour imaging scores of 1 and 2 are benign (p<0.001). Out of the 73 histopathologically benign nodules 65 (89%) returned a score of 1 and 2, whilst 8 (11%) returned a score of 3 and 4. Out of the histopathologically malign 37 nodules 31 returned a score of 3 and 4 whilst, 6(%16) returned a score of 2. Conclusion: This study suggests that elastography presents high degree of sensitivity and specificty in diagnosing breast lesions Ultrasound combined with Elastografi method can be used to distinguish malign and benign lesions in breast. Key Words: Elastography, US strain imaging, breast, ultrasonography,
Purpose: To prospectively evaluate the sensitivity and specificity of ultrasonographic (US) elastography for distinguishing between benign and malignant solid breast masses, with pathologic results as the reference standard. Methodology: Breast lesion identified 96 patients admitted to the Department of Marmara University Radiodiagnostik for percutaneous biopsy in the study. Hundred and ten lesions in patients evaluated prospectively with conventional US and real-time elastography technique. Tissue hardness observed in the ultrasound elastography was visually scaled according to the degree of compression is removed from 1 (low degree firmness on entire nodule) to 4 (high degree firmness on entire nodule and peripheral tissue). Findings: The US elastography evaluation; 83% sensitivity, 89% specifity, 79% positive predictive value and 91% negative predictive value assuming that tumour imaging scores of 3 and 4 are malign and tumour imaging scores of 1 and 2 are benign (p<0.001). Out of the 73 histopathologically benign nodules 65 (89%) returned a score of 1 and 2, whilst 8 (11%) returned a score of 3 and 4. Out of the histopathologically malign 37 nodules 31 returned a score of 3 and 4 whilst, 6(%16) returned a score of 2. Conclusion: This study suggests that elastography presents high degree of sensitivity and specificty in diagnosing breast lesions Ultrasound combined with Elastografi method can be used to distinguish malign and benign lesions in breast. Key Words: Elastography, US strain imaging, breast, ultrasonography,