Rasime Pelin KAVAK, Nezih KAVAK, Savaş BABA, Murat Özgür KILIÇ, Gül DAĞLAR

BI-RADS5 Meme Lezyonlarında Sonoelastografinin Tanısal Yeri

Amaç: Son yıllarda meme lezyonlarının değerlendirilmesinde sonoelastografi giderek daha fazla kullanılmaktadır. Çalışmamızın amacı Meme Görüntüleme Raporlama ve Veri Sistemi (BI-RADS) 5 olan meme lezyonların sonoelastografi incelemesi ile saptanan elastografi skoru ve histopatolojik sonuçlarını karşılaştırmak ve sonoelastografinin meme tümörlerinin malignitesini belirlemedeki kullanılabilirliğini belirlemektir.Gereç ve Yöntemler: Prospektif çalışmamız Aralık 2014 Şubat 2015 tarihleri arasında yapıldı. Ultrasonografide BI-RADS 5 olarak değerlendirilen 44 hastanın yaş, kitle yeri, büyüklüğü, elastografi skorları ve eksizyonel biyopsi sonuçları değerlendirildi.Bulgular: Çalışmamızdaki hastaların yaş ortalaması 50.02±14.28 yıl idi. Hastaların %52.3’ünde kitle sol memede idi ve kitlelerin ortalama boyu 16.93±12.96 mm ve ortalama eni 23.39±14.77 mm’idi. Olguların %97.7’si maligndi. En sık rastlanılan kitle patolojik tipi invazif duktal karsinomdu (%86.4). Çalışmamızda elastografinin duyarlılığı %97.7 olarak saptandı. Malign grubun elastikiyet skoru ve malignite varlığı arasında anlamlı ilişki saptanmadı (p>0.05). Sonuç: Non-invaziv, tekrarlanabilir ve kullanımı kolay bir görüntüleme yöntemi olan sonoelastografi, malign meme lezyonlarının (BI-RADS 5) gösterilmesinde sensitivitesi oldukça yüksek bir test olup, malign meme lezyonlarının ayrımında kullanılabilir.

Anahtar Kelimeler:

BI-RADS 5, sonoelastografi, malign meme kanseri

DIAGNOSTIC VALUE OF SONOELASTOGRAPHY IN BI-RADS 5 BREAST LESIONS

Objective: Sonoelastography is increasingly used in the evaluation of breast lesions in recent years. The aim of our study is to compare the sonoelastography scores found in the sonoelastography examination and histopathological results of Breast Imaging Reporting and Data System (BI-RADS) 5 breast lesions and to determine the usefulness of sonoelastography for identifying the malignancy of the breast tumors.Material and Methods: Our prospective study evaluated the age, mass location, size, elastography score, and excisional biopsy results of 44 patients assessed as BI-RADS 5 on ultrasonography between December 2014 and February 2015.Results: The mean age of the study population was 50.02±14.28 years. In 52.3% of the patients, the mass was located in the left breast the masses had a mean length of 16.93±12.96 mm and a mean width of 23.39±14.77 mm. Ninety-seven-point seven percent of the cases were malignant in nature. The most common mass histopathology was invasive ductal carcinoma (86.4%). The sensitivity of sonoelastography was 97.7%. No relationship between the elasticity score and the presence of malignancy in the malignant group (p>0.05). Conclusion: Sonoelastography, which is a noninvasive, reproducible and easy-to-use imaging method is a highly sensitive test for showing malignant breast lesions (BI-RADS 5) can be used for distinction of malignant breast lesions.

Keywords:

BI-RADS5, sonoelastography, malignant breast cancer,

PDF

___

1. Gerger D, Coşkun ZF, Ertürk A, Uzun Ş. Meme kitlelerinin değerlendirilmesinde elastografi ve difüzyon MRG’nin yeri. Okmeydanı Tıp Dergisi. 2013:29(1):8-14.
2. Yagtu M, Turan E, Turan CO. The role of ultrasonographic elastography in the differential diagnosis of breast masses and its contribution to classical ultrasonographic evaluation. J Breast Health. 2014;10(3):141-6.
3. Yakut ZI, Kurt A, Karabekmez LG, Ogur T. Breast Sonoelastography. Abant Med J. 2015;4(3):309-16.
4. Zhi H, Ou B, Luo BM, Feng X, Wen YL, Yang HY. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med. 2007;26(6):807-15.
5. Zhu QL, Jiang YX, Liu JB, Liu H, Sun Q, Dai Q et al. Real-time ultrasound elastography: Its potential role in assessment of breast lesions. Ultrasound Med Biol. 2008;34(8):1232-8.
6. Gültekin S. Ultrasonografide Yeni Uygulamalar. Türk Radyoloji Derneği Seminerleri. 2014;2:158-70.
7. Balleyguier C, Ciolovan L, Ammari S, Canale S, Sethom S, Al Rouhbane R et al. Breast elastography: the technical process and its applications. Diag Interv Imaging. 2013;94(5):503-13.
8. Garra BS. Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q. 2007;23(4):255-68.
9. American College of Radiology. Breast imaging reporting and data system (BI-RADS), Ultrasound. Accessed date: 8 September 2004: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/Bi-Rads#Ultrasound.
10. Scaperrotta G, Ferranti C, Costa C, Mariani L, Marchesini M, Suman L et al. Role of sonoelastography in nonpalpable breast lesions. Eur Radiol. 2008;18(11):2381-9.
11. Onur MR, Göya E. Ultrason elastografi: Abdominal uygulamalar. Türkiye Klinikleri J Radiol. 2013;6:59-69.
12. Krouskop TA, Younes PS, Srinivasan S, Wheeler T, Ophir J. Differences in the compressive stress-strain response of infiltrating ductal carcinomas with and without lobular features implications for mammography and elastography. Ultrason Imaging. 2003;25(3):162-70.
13. Yi A, Cho N, Chang JM, Koo HR, La Yun B, Moon WK. Sonoelastography for 1786 non-palpable breast masses: diagnostic value in the decision to biopsy. Eur Radiol. 2012;22(5):1033-40.
14. Yerli H, Yilmaz T, Kaskati T, Gulay H. Qualitative and semi-quantitative evaluations of solid breast lesions by sonoelastography. J Ultrasound Med. 2011;30(2):179-86.
15. Thomas A, Kümmel S, Fritzsche F, Warm M, Ebert B, Hamm B et al. Real-time sonoelastography performed in addition to B-mode ultrasound and mammography: improved differentiation of breast lesions? Acad Radiol. 2006;13(12):1496-1504.
16. Stavros AT, Thickman D, Rapp CL, Dennis MA, Parker SH, Sisney GA. Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology. 1995;196(1):123-34.
17. Yi A, Cho N, Chang JM, Koo HR, La Yun B, Moon WK. Sonoelastography for 1,786 non-palpable breast masses: diagnostic value in the decision to biopsy. Eur Radiol 2012;22(5):1033-40. Doi:10.3348/kjr.2013.14.4.559.
18. Türker MF, Tok US, Akça T, Karabacak T, Esen K, Balcı Y et al. Diagnostic value of ultrasound elastography characterization of solid breast lesions. JAREM 2017;7:74-81.
19. Schaefer FK, Heer I, Schaefer PJ, Mundhenke C, Osterholz S, Order BM et al. Breast ultrasound elastography results of 193 breast lesions in a prospective study with histopathologic correlation. Eur J Radiol. 2011;77(3):450-6.
20. Moon WK, Huang CS, Shen WC, Takada E, Chang RF, Joe J et al. Analysis of elastographic and B-mode features at sonoelastography for breast tumor classification. Ultrasound Med Biol. 2009;35(11):1794-802.
21. Leong LC, Sim LS, Lee YS, Ng FC, Wan CM, Fook-Chong SM et al. A prospective study to compare the diagnostic performance of breast elastography versus conventional breast ultrasound. Clin Radiol. 2010;65(11):887-94.