Enis YÜKSEL, Sema YILDIZ, Özlem TÜRKSOY, Nurdan BARÇA, Levent ARAZ

Solid meme lezyonlarını değerlendirmede B-mod, renkli doppler ve power doppler ultrasonografinin yeri

Amaç: Bu çalışmada, solid meme kitlelerinde, malign lezyonların benign kitlelerden ayırdedilmesinde B-mod, renkli ve power dopler ultrasonografinin (US) önemi araştırılmıştır. Hastalar ve Yöntem: Biyopsi sonucu olan 83 solid meme kitlesi (25 malign; 58 benign) 7,5-12 MHz lineer problar kullanılarak B-mod, renkli ve power dopler US ile değerlendirildi. Kitlelerdeki dopler vasküler akım sinyallerinin lokalizasyonu, dağılımı ve şekli incelendi. Bu akımlar santral, periferal ve santral+ periferal olarak gruplandırıldı. B-mod US ile, lezyonların Transvers/ sagittal (T/ S) oranları; ekojeniteleri; akustik şiddetlenme/ zayıflamaları değerlendirildi. Sonuçlar: Renkli ve power dopler US’de artmış vaskülarite, malign potansiyelin güçlü bir belirleyicisidir. p değeri anlamlı çıkmamakla birlikte, periferal+ santral vaskülaritenin saptanması; rezistivite indeksinin 0,75’den (duyarlılık: %85, özgüllük: %92); pulsatilite indeksinin 1,6’dan (duyarlılık: %95, özgüllük: %68) büyük olması lezyonun malign çıkma ihtimalini güçlendirmektedir. Ayrıca, B- mod US ile saptanan T/ S oranındaki artışın malignite riski ile ilişkili olduğu görülmüştür. Tartışma: Konvansiyonel B-mod US’e ilave olarak renkli ve power dopler US, malign lezyonları benign kitlelerden ayırmada değerli bilgiler vermektedir.

The value of B-mode, color doppler and power doppler ultrasonography in the evaluation of solid breast lesions

Aim: This study analyzed the B- mode, color and power Doppler signals in solid breast masses and assessed their value in differentiating malignant from benign lesions. Patient and Methods: Eighty-three biopsy-proven solid breast masses (25 malignant and 58 benign) were evaluated with B-mode, color and/ or power Doppler ultrasonography (US) using a 7,5- 12 MHz linear-array transducer. We analyzed the location, shape, and penetration of the Doppler vascular signals in the breast masses. The location of the vascular signals was categorized as central, peripheral or both. With B-Mode US, Transverse/ sagittal (T/ S) ratios of lesions; echogenicity; acoustic enhancement/ decrease were also evaluated. Results: Increased vascularity both in color and power doppler US, is a strong indicator for malignancy. Although the p value is insignificant, doppler features suggestive of malignant lesions were the presence of both peripheral and central vascularity; resistivity index greater than 0,75 (sensitivity: 85%, specificity: 92%) and pulsatility index greater than 1,6 (sensitivity: 95%, specificity: 68%). Also, increase in T/ S ratio measured by B-mode US was suggestive of malignancy. Conclusions: Color and Power Doppler imaging are both valuable adjunct to conventional Bmode sonography in differentiating between malignant and benign breast lesions.

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