Cansu ÖZTÜRK, Özlem GÜNGÖR, Derya BULUŞ, Merve KAŞIKCI, Selma UYSAL RAMADAN

TELARŞLI PUBERTE PREKOKS HASTALARINDA VASKÜLARİTENİN DOPPLER ULTRASONOGRAFI YÖNTEMLERİ İLE DEĞERLENDİRİLMESİ

AMAÇ: Bu çalışmanın amacı; telarş değerlendirilmesinde meme vaskülarite düzeyi ile Tanner evrelemesi arasındaki korelasyonun araştırılması ve vaskülaritenin gösterilmesinde doppler yöntemlerinin karşılaştırılmasıdır.GEREÇ VE YÖNTEM: Ekim - Aralık 2017 tarihleri arasında puberte prekoks ön tanısı ile başvuran ve memede şişlik şikâyeti olan, radyoloji kliniğine refere edilen 6-10 yaş arası kız çocukları çalışmaya dahil edildi. Katılımcıların hepsine meme ultrasonografi (US) ve renkli doppler ultrasonografi (CDUS) tetkiki yapıldı. Tüm katılımcıların takvim yaşı, Folikül Stimülan Hormon (FSH), Luteinizan Hormon (LH), Estradiol (E2), telarş evresi, her iki meme volümü değerlendirildi. Her iki meme için renkli doppler (CD), Power doppler (PD) ve superb mikrovasküler görüntüleme (SMI) yöntemleri kullanılarak vasküler skorlar ölçüldü.BULGULAR: Çalışmaya 116 kız çocuğu, 213 telarşlı meme dahil edildi. Her bir meme için ölçülen derinlik transvers, longitudinal çap ölçümleri ve meme volümü ile sonografik Tanner sınıflaması arasında anlamlı korelasyon bulundu (sırasıyla: rs=0,762, rs=0,830, rs=0,774 rs=0,824, p<0,001). Doppler yöntemleri arasında en yüksek korelasyon PD’de saptanmakla birlikte (PD rs =0,68, CD rs =: 0,61, SMI rs =:0,61, p<0,001) yöntemlerin birbirlerine üstünlükleri yoktu (p>0,05). PD ile damarlanma gösterilemeyen 65 memeden 30'unda SMI ile damarlanma gösterildi. Bu 30 olgunun %90’ ı (n:27) Tanner evre I ve II’ydi.SONUÇ: Sonuç olarak; SMI tekniği telarş vaskülaritesinin değerlendirilmesinde konvansiyonel doppler yöntemleri kadar başarılı olmakla birlikte bazı olgularda daha fazla veri sağlayabilir.

Anahtar Kelimeler:

Puberte prekoks, Ultrasonografi, Doppler, Meme, Puberty precocious, Ultrasonography, Breast

ASSESSMENT OF VASCULARITY WITH DOPPLER ULTRASONOGRAPHY METHODS IN PATIENTS OF PUBERTY PRECOCIOUS WITH THELARCHE

OBJECTIVE: The aim of this study is to investigate the correlation between breast vascularity level and Tanner staging in the evaluation of thelarche, and to compare Doppler methods for demonstrating vascularity.MATERIAL AND METHODS: Girls aged 6–10 who were referred to the radiology clinic with a complaint of breast swelling and prediagnosed with precocious puberty between October and December 2017 were included in the study. Breast ultrasonography (US) and color doppler ultrasonography (CDUS) examinations were performed on all participants. Age, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), thelarche stage, both breast volumes were recorded for all participants. Vascular scores were measured for both breasts using imaging modalities such as color doppler (CD), Power US (PD), and superb microvascular imaging (SMI).RESULTS: We included 116 girls and 213 thelarche breasts in the study. A significant correlation was found between the depth and transverse and longitudinal diameter for each breast and breast volume and Tanner stages (rs = 0.762, rs = 0.830, rs = 0.774 rs = 0.824, respectively; p < 0.001). Although the highest correlation between Doppler methods was found in PD (PD rs =0.68, CD rs =: 0.61, SMI rs =:0.61, p<0.001), the methods did not have any superiority over each other (p>0.05). Vascularization with SMI was demonstrated in 30 of 65 breasts for which vascularization could not be demonstrated with power Doppler. Among these 30 cases, 90% (n = 27) were Tanner stage I and II.CONCLUSIONS: In conclusion, although SMI is as successful as conventional Doppler methods in the evaluation of thelarche vascularity, it can provide more data in some cases.

Keywords:

Puberty precocious, Ultrasonography, Breast,

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