MEME KANSERLİ HASTALARDA CERRAHİ TEDAVİNİN PLANLANMASINDA KONTRASTLI DİNAMİK MULTİ-DEDEKTÖR TOMOGRAFİ GÖRÜNTÜLEMENİN ROLÜ

Year 2006, Volume: 19 Issue: 3, 109 - 115, 26.06.2015

Taner Yiğit Unsal Coskun Öner Menteş Mentes Oner Cengizhan Yigitler Gulec Bulent Bülent Güleç Müjdat Balkan Orhan Kozak Tufan Turgut Turgut Tufan

Abstract

Giriş: Meme kanserinin cerrahi tedavisinin başarısı temel olarak hastalık tekrarının önlenmesi prensibine
dayanmaktadır. Günümüzde manyetik rezonans görüntüleme meme kanserinin tanısında yoğun olarak
kullanılmaktadır. Buna karşın kapalı alan korkusu olan hastalara bu tetkikin uygulanmasında güçlükler ve
kolay ulaşılabilirliğin kısıtlı olması manyetik rezonans görüntülemenin uygulanabilirliğinin sınırlamaları
olarak karşımıza çıkmaktadır. Bu çalışmada bölgesel hastalık tekrarı gelişiminde önemli etkenlerden olan
tümörün çevre yapılarla olan ilişkisi ve uydu tümör odaklarının varlığının incelenmesinde kontrastlı dinamik
çok detektörlü tomografinin manyetik rezonans görüntülemeye alternatif olarak kullanılabilirliğini araştırdık.
Materyal Yöntem: 18 aylık dönem içinde meme kanseri tanısı konmuş ve meme koruyucu cerrahi
planlanan toplam 30 hastaya kontrastlı dinamik çok detektörlü tomografi uygulandı.
Sonuçlar: İki hastada (10%) tümörün pektoral kas kılıfına çok yakın sonlandığı, üç hastada (15%) uydu
tümör odağı varlığı tespit edildi. Bu hastaların birinde ise uydu tümör odağına ilave olarak pektoral kas
kılıfına yakın sonlanma tespit edildi. Hastaların dördüne de aydınlatılmış onamları alınarak meme koruyucu
cerrahi yerine modifiye radikal mastektomi ameliyatı uygulandı.
Tartışma: Kontrastlı dinamik çok detektörlü tomografi, seçilmiş vakalarda manyetik rezonans
görüntülemeye iyi bir alternatiftir. Kontrastlı dinamik çok detektörlü tomografi ile ana tümörün pektoral kas
kılıfına ile olan ilişkisi ve uydu tümör odakları hakkında yararlı veriler elde edilebilmektedir.

Keywords

Meme kanseri, Çok detektörlü CT, Tanı, Tedavi

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