Jinekomasti Hastalarında Ultrason Elastografi Bulgularının Değerlendirilmesi

GİRİŞ ve AMAÇ: Jinekomasti tanısı alan erişkin hastalarda jinekomasti tanısında ve tiplerinin belirlenmesinde ultrason elastografinin (UE) etkinliğinin değerlendirmesi ve elastografinin tanıya katkısının araştırılması amaçlanmıştır. YÖNTEM ve GEREÇLER: Çalışmaya Kasım 2016 – Şubat 2017 tarihleri arasında kliniğimize jinekomasti ön tanısıyla gönderilen ve sonografik olarak jinekomasti tanısı konulan 26 hasta dahil edildi. Jinekomasti ile ilişkili olabilecek hastalıklar ve ilaç kullanım öyküsü sorgulandı. Jinekomastisi bulunmayan 30 sağlıklı erişkin kontrol grubuna dahil edildi. Hasta ve kontrol gruplarının vücut kitle indeksi (BMI) hesaplandı. B-mod ultrasonografi ile jinekomasti dokusunun boyutu ve paterni (nodüler, dendritik, diffüz) değerlendirildi. UE incelemede bu dokunun gerinim oranı kaydedildi. Kontrol grubunda ise retroareoler rudimente meme dokusuna ve aynı derinlikteki referans yağ dokusuna ROİ yerleştirildi ve gerinim oranı kaydedildi. BULGULAR: : Jinekomasti dokusunda gerinim oranı, rudimenter meme dokusuna göre anlamlı derecede yüksekti (p

Evaluation of Ultrasound Elastography Findings in Gynecomastia Patients

INTRODUCTION: We aimed to evaluate the efficacy of ultrasound elastography in the diagnosis of gynecomastia and to identify its types in adult patients. METHODS: A total of 26 adult patients diagnosed as gynecomastia were included in the study. All patients were questioned in terms of diseases that may cause gynecomastia and drug use history. The control group consisted of age-matched 30 healthy individuals without gynecomastia. Body mass index (BMI) values were measured and recorded in both patient and control groups. The dimensions of the gynecomastia tissue were calculated via B-mode ultrasound and the pattern (nodular, dendritic, diffuse) of gynecomastic tissue was analyzed. The strain ratio was recorded using ultrasound elastography. In the control group, the region of interest (ROI) was inserted into the retroareolar rudimentary breast tissue and into the reference adipose tissue at the same depth, and strain ratio was recorded. RESULTS: The strain ratio was significantly higher in the gynecomastia tissue (p

PDF

___

1. Ismail AA, Barth JH. Endocrinology of gynecomastia. Ann Clin Biochem 2001; 38: 596-607.
2. Tangerud A, Potapenko I, Skjerven HK, Stensrud MJ. Radiologic evaluation of lumps in the male breast. Acta Radiol. 2016; 57: 809-14.
3. Adibelli ZH, Oztekin O, Postaci H, Uslu A. The Diagnostic Accuracy of Mammography and Ultrasound in the Evaluation of Male Breast Disease: A New Algorithm. Breast Care. 2009; 4: 255-9.
4. Telegrafo M, Introna T, Coi L, Cornacchia I, Rella L, Stabile Ianora AA, et al. Breast US as primary imaging modality for diagnosing gynecomastia. G Chir. 2016; 37: 118-22.
5. Appelbaum AH, Evans GF, Levy KR, Amirkhan RH, Schumpert TD. Mammographic appearances of male breast disease. Radiographics. 1999; 19: 559-68.
6. Draghi F, Tarantino CC, Madonia L, Ferrozzi G. Ultrasonography of the male breast. J Ultrasound. 2011; 14: 122-9.
7. Ferron S, Asad-Syed M, Boisserie-Lacroix M, Lippa N, Palussiere J, Hurtevent-Labrot G. Elastography as predictor of malignancy in male breast cancer. Poster presented at: ECR 2013; Vienna.
8. Çebi Olgun D, Korkmazer B, Kılıç F, Dikici AS, Velidedeoğlu M, Aydoğan F, et al. Use of shear wave elastography to differentiate benign and malignant breast lesions. Diagn Interv Radiol. 2014; 20: 239-44.
9. Mainiero MB, Lourenco AP, Barke LD, Argus AD, Bailey L, Carkaci S, et al. ACR Appropriateness Criteria Evaluation of the Symptomatic Male Breast. J Am Coll Radiol 2015; 12: 678-82.
10. Lapid O, Siebenga P, Zonderland HM. Overuse of imaging the male breast-findings in 557 patients. Breast J. 2015; 21: 219-23.
11. Hanavadi S, Monypenny IJ, Mansel RE. Is mammography overused in male patients? Breast. 2016; 15:123-6.
12. Hines SL, Tan WW, Yasrebi M, DePeri ER, Perez EA. The role of mammography in male patients with breast symptoms. Mayo Clin Proc. 2007; 82: 297-300.
13. Dialani V, Baum J, Mehta TS. Sonographic Features of Gynecomastia. J Ultrasound Med. 2010; 29: 539-47.
14. Braunstein G.D. Clinical practice. Gynecomastia. N Engl J Med. 2007; 357: 1229-37.
15. Gheonea IA, Stoica Z, Bondari S. Differential diagnosis of breast lesions using ultrasound elastography. Indian J Radiol Imaging. 2011; 21: 301-5.
16. Evans A, Whelehan P, Thomson K, Brauer K, Jordan L, Purdie C, et al. Differentiating benign from malignant solid breast masses: value of shear wave elastography according to lesion stiffness combined with greyscale ultrasound according to BI-RADS classification. Br J Cancer. 2012; 107: 224-9.
17. Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T,et al. Breast lesions: quantitative elastography with supersonic shear imaging--preliminary results. Radiology. 2010; 256: 297-303.
18. Krouskop TA, Wheeler TM, Kallel F. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging. 1998; 20: 260-74.
19. Ginat DT, Destounis SV, Barr RG, Castaneda B, Strang JG, Rubens DJ. US elastography of breast and prostate lesions. Radiographics. 2009; 29: 2007-16.
20. Niewoehner CB, Nuttal FQ. Gynecomastia in a hospitalized male population. Am J Med. 1984; 77: 633-8.