Türkiye’de Meme Ultrasonografi Raporlarının ACR-BIRADS Kriterlerine Uyumunun Değerlendirilmesi: Retrospektif Çok Merkezli Bir Analiz

Abstract

Amaç: Bu çalışma, Türkiye’de farklı sağlık kurumlarında hazırlanan meme ultrasonografi raporlarının Amerikan Radyoloji Koleji (ACR) BI-RADS 5. baskı standartlarına (yapı, teknik özellikler ve tanısal sonuçlar açısından) uyumunu değerlendirmeyi amaçladı. Yöntem: 2015–2020 yılları arasında 32 hastaneden, farklı radyologlar tarafından hazırlanmış toplam 230 meme ultrasonografi raporu retrospektif olarak incelendi. Raporlar; üniversite hastaneleri, eğitim ve araştırma hastaneleri, devlet hastaneleri ve özel hastanelerden elde edildi. Her rapor, BI-RADS rehberine göre; teknik parametreler, sonografik tanımlayıcılar, BI-RADS kategorileri ve klinik öneriler açısından değerlendirildi. Bulgular: Lezyon boyutu ve lokalizasyonu sırasıyla %98–99 oranında raporlanmıştı. Ancak önemli tanımlayıcılar sıklıkla eksikti: şekil (%22), yerleşim/orientasyon (%15), posterior akustik özellikler (%10), vaskülarite (%20) ve elastisite (%3). Lezyonun meme ucuna uzaklığı sadece %43 olguda belirtilmişti. BI-RADS kategorisi raporların %58’inde, klinik öneriler ise %52’sinde yer aldı. Hasta kimlik bilgileri ve inceleme tarihi tüm kurumlarda düzenli raporlanmıştı. Üniversite ve eğitim hastanelerinde klinik öykü ve önceki görüntülemelerin kaydedilme oranı devlet ve özel hastanelere göre anlamlı olarak daha yüksekti (p<0,05). Doku kompozisyonu raporlama oranı devlet hastanelerinde en düşük bulundu (p<0,05). BI-RADS kategorisi ve yorumların yer alması da devlet hastanelerinde diğer kurumlara göre anlamlı derecede düşüktü (p<0,05). Sonuç: Temel lezyon özellikleri genellikle raporlanmakla birlikte, malignite risk değerlendirmesi için kritik öneme sahip sonografik tanımlayıcılar yeterince kullanılmamaktadır. Özellikle devlet hastanelerinde raporlama kalitesini artırmak için yapılandırılmış rapor şablonlarının uygulanması ve BI-RADS ilkeleri konusunda rutin eğitimler gereklidir.

Keywords

• ACR
• meme ultrasonografi
• BI-RADS

Evaluation of Compliance of Breast Ultrasound Reports with ACR-BIRADS Criteria: A Retrospective Multicenter Analysis in Turkey

Abstract

Background: This study evaluated the adherence of breast ultrasound reports from various healthcare institutions in Turkey to the American College of Radiology (ACR) BI-RADS 5th edition standards regarding structure, technical features, and diagnostic conclusions. Methods: A total of 230 breast ultrasonography reports from 32 hospitals, prepared by different radiologists between 2015 2020, were retrospectively analyzed. The reports originated from four types of healthcare facilities: university hospitals, training and research hospitals, state hospitals, and private hospitals. Each report was reviewed based on BI-RADS guidelines, assessing technical parameters, sonographic descriptors, inclusion of BI-RADS categories, and clinical recommendations. Results: Lesion size and location were documented in 98%- 99% of reports, respectively, but key descriptors were often missing: shape(22%), orientation(15%), posterior acoustic features (10%), vascularity(20%), and elasticity(3%). The lesion’s distance from the nipple was specified in 43%of cases. BI-RADS categorization was included in 58% of reports, and management recommendations in 52%. No differences were found in reporting patient identifiers or examination date among institutions. University and training hospitals more frequently documented clinical history and prior imaging compared to state and private hospitals(p<0.05). Tissue composition reporting was lowest in state hospitals(p<0.05). BI-RADS categorization and comments were significantly less frequent in state hospitals than in other groups(p<0.05). Conclusion: Despite consistent reporting of basic lesion features, critical sonographic descriptors essential for malignancy risk assessment remain underutilized. Structured reporting templates and routine training in BI-RADS principles are needed, particularly in state hospitals, to improve communication with clinicians and optimize patient management.

Keywords

• ACR
• breast ultrasound
• BI-RADS

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