Hande Uslu, Mesude Tosun, Burcu Alparslan, Özgür Çakır, İsa Çam

Meme Kitlelerinin Vaskülaritesini Değerlendirmede Süperb Mikrovasküler Görüntülemenin Faydaları: Renkli ve Power Doppler Görüntüleme ile Tanısal Performans Karşılaştırması

Amaç: Bu çalışmanın amacı meme kitlelerindeki vaskülariteyi değerlendirmek için, Renkli Doppler Görüntüleme (RDG), Power Doppler Görüntüleme (PDG) ve Süperb Mikrovasküler Görüntüleme (SMG) yaparak elde ettiğimiz bulguları, histopatolojik sonuçlar ile karşılaştırıp tanısal etkinliklerini değerlendirmektir. Yöntem: Belirtilen tarih aralığında, dahil etme kriterlerine uygun 46 hastaya gri skala USG, RDG, PDG ve SMG yapıldı. Her bir kitlenin vaskülarite özellikleri kaydedildi ve karşılaştırıldı. Bulgular: Kırk altı meme lezyonundan 26’sı benign ve 20’si maligndi. 26 benign lezyondan 19 tanesi fibroadenom, 5 tanesi granülomatöz mastit ve 2 tanesi sklerozan adenozis iken 20 malign lezyonun tamamı invaziv duktal karsinomdu. Benign lezyonlarda ortalama boyut 21,5± 9,6mm, malign lezyonlarda 12,4± 5,8mm idi. Renkli SMG (rSMG) ile malign lezyonlarda benign lezyonlardan daha fazla penetran damar (PV) tespit edilmiş olup malign lezyonlar için rSMG tarafınca tespit edilen PV sayısı, RDG ve PDG tarafınca tespit edilenden daha fazladır. Benign lezyonlarda rSMG ve RDG ile, PDG’ye kıyasla daha az PV tespit edildi. PV varlığı malignite tanısı için bir kriter olarak kullanıldığında, rSMG’nin duyarlılık, özgüllük, pozitif prediktif değer (PPD), negatif prediktif değer (NPD) ve tanısal doğruluğu, RDG ve PDG'ninkinden daha yüksekti. RDG ve PDG ile karşılaştırıldığında, rSMG ile daha fazla akım sinyali ve damar morfolojisi tespit edildi. Meme lezyonlarındaki vasküler paternlere göre farklı görüntüleme modalitelerinin tanısal etkinliğinde rSMG’nin duyarlılık, PPD, NPD ve tanısal doğruluğu, RDG ve PDG’ninkinden daha yüksekken, özgüllüğü daha düşüktü. Sonuç: rSMG, RDG ve PDG’den daha fazla vasküler dallanma detayı göstermekte olup benign-malign meme lezyonunun ayırt edilmesinde uygulanabilir bir yöntemdir.

Anahtar Kelimeler:

Meme kitlesi, RDG, PDG, SMG, Benign, Malign

Benefits of Superb Microvascular Imaging in Vascularity Evaluation of Breast Masses: Diagnostic Performance Comparision with Color and Power Doppler Imaging

Objective: This study aims to compare findings of Color Doppler Imaging (CDI), Power Doppler Imaging (PDI) and Superb Microvascular Imaging (SMI) with histopathological results to evaluate their diagnostic efficacy for evaluating the vascularity in breast masses. Methods: Gray-scale US, CDI, PDI, and SMI were performed on 46 patients who met the inclusion criteria during the specified date range. The vascularity characteristics of each mass were recorded and compared. Results: Of the 46 breast lesions, 26 were benign and 20 were malignant. While all 20 malignant lesions were invasive ductal carcinoma, benign lesions included 19 fibroadenomas, 5 granulomatous mastitis and 2 sclerosing adenosis. Mean size was 21.5± 9.6mm in benign lesions and 12.4± 5.8mm in malignant lesions. Color SMI (cSMI) detected more penetrating vessels (PV) in malignant lesions than benign lesions, and the number of PV detected by cSMI for malignant lesions was higher than those detected by CDI and PDI. In benign lesions, less PV was detected with cSMI and CDI than PDI. When the presence of PV was used as a criterion for the diagnosis of malignancy, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of cSMI were higher than CDI and PDI. In distinguishing vascular patterns in breast lesions, the sensitivity, PPV, NPV, and diagnostic accuracy of cSMI were higher, while the specificity was lower than those of CDI and PDI. Conclusion: cSMI shows more vascular branching details than CDI and PDI and is a viable method in differentiating benign-malignant breast lesion.

Keywords:

Breast mass, CDI, PDI, SMI, benign, malignant,

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