Direnç Özlem AKSOY, Zeynep Gamze KILIÇOĞLU, Mehmet Masum ŞİMŞEK, Seçil TELLİ, Gökalp YILMAZ, Ercüment KADIOĞLU

Dinamik kontrastlı meme magnetik rezonans görüntülemesinde tanımlanmış skorlama sisteminin ve eklenebilecek kantitatif verilerin tanıya katkısı

Amaç: Dinamik kontrastlı magnetik rezonans görüntüleme (DK-MRG) tekniği ile meme kitlelerinin değerlendirilmesinde tanımlanmış olan skorlama sisteminin ve farklı kantitatif verilerin, lezyonların malign veya benign ayırımındaki katkısını değerlendirmek. Hastalar ve Yöntem: Çalışmamızda 95 lezyon, meme görüntülemeraporlama ve veri [(breast imaging-reporting and data system (BIRADS)] sisteminin analoğu olarak kabul edilebilecek bir skorlama sistemi (Fischer’s score) ile değerlendirildi. Ayrıca kinetik verilerden hesaplanan kantitatif parametreler time to peak enhancement (Tpeak), maximum slope of enhancement curve (Smax) ve washout değerleri hesaplandı. Bulgular istatistiksel olarak değerlendirildi. Bulgular:Fischer skorlama sisteminin total puanının değerlendirilmesinde sırasıyla 0-3, 4 ve 5-8 puanların spesifite değerleri: %23,40, %78,87 ve %97,87 bulunmuştur. Skorlama sisteminin parametreleri ayrı ayrı değerlendirildiğinde: morfolojik özelliklerden şekil, istatistiksel olarak en anlamlı (p=0,001) grup olarak karşımıza çıkmaktadır. Halkasal kontrastlanma ise spesifitesi en yüksek morfolojik parametredir (%97,87). Kinetik verilerden erken dönem kontrastlanma yüzdesinin malign ve benign lezyonlarda anlamlı farklılık göstermediği görülmektedir.. Kinetik eğri tipleri, tip 1 ve tip 2-3 şeklinde değerlendirmeye katıldığında istatistiksel olarak anlamlı bulunmuştur (p=0,001). Kantitatif parametrelerden Tpeak ve Smax istatistiksel olarak anlamlı bulundu. Sonuç: Morfolojik parametreler ile kinetik eğri verilerinin birlikte değerlendirildiği skorlama sistemi, lezyonların benign-malign ayırımında faydalı bilgiler sağlamaktadır. Ayrıca, kantitatif parametrelerden anlamlı bulunan Tpeak ve Smax değerlerinin de tanısal başarıya katkı sağlayabilecek potansiyele sahip veriler olduğu düşünülmektedir.

Anahtar Kelimeler:

Meme, DK-MRG, Dinamik, Kantitatif, Skorlama

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Objective: To assess whether identified scoring system and various guantitative data would help clinicians to distinguishing malignant from benign breast lesions more accurately on the dynamic contrast enhancedmagnetic resonance images (DCE-MRI).Patients and Methods: Ninety-five lesions included in our research were evaluated by a scoring system (Fischer’s score) that can be accepted as an analogue of breast imaging-reporting and data systems (BI-RADS). Time to peak enhancement (Tpeak), maximum slope of enhancement curves (Smax) and washout values which are quantitative parameters computed from kinetic data were calculated.Results: In the evaluation the Fischer scoring system, specificities of total points 0-3, 4 and 5-8 were 23.40%, 78.87% and 97.87% respectively. The parameters of the scoring system showed that the shape of a lesion which is one of the morphologic characteristics, was statistically the most significant parameter (p=0.001). Rim enhancement had the highest specificity (97.87%) of the morphologic parameters. There was no significant difference between malignant and benign lesions in the percentage of early enhancement when we examined the kinetic data. There was significant difference between kinetic curves of type 1 compared to types 2-3 (p=0.001). The quantitative parameters Tpeak and Smax, were statistically significant.Conclusion: Scoring systems in which both morphologic parameters and kinetic curves are evaluated give useful information in distinguishing benign from malignant breast lesions. Also, statistically significant Tpeak and Smax quantitative values can be useful in the diagnosis of breast lesions.

Keywords:

Breast, DCE-MRI, Dynamic, Quantitative, Scoring,

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