Neşe ASAL, Aynur TURAN, Esin ÖLÇÜCÜOĞLU, Pelin Seher ÖZTEKİN, Işıl TUNÇBİLEK, Ömer YILMAZ

Manyetik Rezonans Görüntülemenin Meme Kanserini Saptamadaki Yeri

Amaç: Çalışmamızın amacı meme Manyetik Rezonans Görüntüleme (MRG) incelemesinin tanısal değerini mamog- rafi (MG) ve ultrasonografi (US) ile karşılaştırarak, bulguları biyopsi sonuçları ile korele ederek meme kanserini sap- tamadaki değerini vurgulamaktır. Yöntem ve Gereçler: Çalışmaya meme MRG incelemesi yaptıran 320 olgu dahil edildi. Olgulara meme MRG ön- cesi sırasıyla MG ve US tetkikleri yapıldı. Tüm tetkiklerin arasındaki süre 2 ayı geçmeyecek şekilde planlandı vedeğerlendirme iki radyolog tarafından yapıldı. İncelemelerin değerlendirilmesi BI-RADS sınıflamasına göre yapıldı.MRG incelemesi sonucunda BI-RADS 4 ve 5 tanısı konan olgulara biyopsi önerildi. Takip önerilen BI-RADS 3 tanısıalan olgulardan da fizik muayene bulguları nedeniyle biyopsi yapılanlar oldu. Biyopsi sonuçları ile MG, US ve MRGbulguları karşılaştırıldı. Bulgular: Çalışmamızda BI-RADS 4 ve 5 grubunda biyopsi önerilen 63 olgudan 36sına meme kanseri (32 invazivduktal karsinom, 2 invaziv lobüler karsinom, 1 lenfoma, 1 anjiosarkom) teşhisi kondu. BI-RADS 4 grubunda olgu- ların %16'sına, BI-RADS 5 grubunda olguların %94'üne meme kanseri tanısı kondu. BI-RADS 1 grubunda olup ak- siller lenfadenopatisi olan bir olguda MRG incelemesi ile meme kanseri tanısı konamadı. Çalışmamızda yalancı po- zitif olguların büyük çoğunluğunu fibrokistik olgular oluşturmaktaydı. Sonuç: Meme lezyonlarının değerlendirilmesinde MRG duyarlılık, özgüllük, pozitif öngörü değeri, negatif öngörüdeğeri ve doğruluk olarak en yüksek oranlara sahip olup; MG ve MRG kombinasyonu, memenin değerlendirilmesin- de en iyi non-invaziv inceleme yöntemleri olarak saptandı.

Magnetic Resonance Imaging in the Detection of Breast Cancer

Aim: The aim of our study is to state and emphasize breast Magnetic Resonance Imaging (MRI) examination s diag- nostic value by comparing it with mammography (MG), ultrasonography (US) and by coraleting these findings withthe results of biopsies done. Material and Methods: 320 patients were included in the study who had breast MRI examination. MG and US wereperformed before MRI examinations. All tests which are in fact planned no later than two months in between andevaluation were performed by two radiologists. BI-RADS classification was used for evaluation.We recommended biopsy for MRI cases evaluated as BI-RADS 4 and 5. We recommended follow-up for cases evaluated as BI-RADS3, some of which went biopsy because of physical examination findings. We compared biopsy results with MG, US,and MRI evaluations.Results: In our 36 out of 63 cases from BI-RADS 4 and 5 group (recommended biopsy) were diagnosed as breastcancer. (32 invasive ductal carcinomas, 2 invasive lobular carcinoma, 1 lymphoma, 1 angiosarcoma) 16% of patientsfrom BI-RADS 4 evaluation group, 94% of patients from BI-RADS 5 evaluation group were diagnosed as breast can- cer. For one patient with axillary lymphadenopathy, MRI examination was evaluated as BI-RADS 1 and MRI was notdiagnostic. In our study majority of false-positive cases were from fibrocystic cases. Conclusion: MRI has the highest sensitivity, specificity, positive predictive value, negative predictive value and accu- racy rates in evaluation of breast lesions, while the combination of MG and MRI was found to be the best non-invasiveexamination method.

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