TOMOGRAFİ VE MAMOGRAFİNİN KARŞILAŞTIRILMASI, BİLGİSAYARLI TOMOGRAFİDE MEME KANSERİNİN TANISAL ÖZELLİKLERİ Features of Breast Cancer on Computerized Tomography with the Comparison of Mammography to Tomography

Öz

ÖZET Amaç: Bu çalışmanın amacı, meme kanserinin bilgisayarlı tomografi (BT)’de tanısal özelliklerini belirlemek ve meme kanserinin tomografi görülebilirlik derecesini araştırmaktır. Gereç ve Yöntem: Mayıs 2010-Ocak 2016 tarihleri arasında histopatolojik tanısı bulunan 1000 meme lezyonu değerlendirildi. Bu lezyonların 604 (% 60,4)'ünde meme kanseri tanısı vardı. 604 meme kanseri olgusunun 161 (% 16.1)’inin mamografi ve toraks BT görüntüleri vardı. Çalışmaya dahil edilen bu 161 lezyonun BT ve mamografi (MG)’de lezyonların tanısal özellikleri, görülebilirlik oranları, malign ek odak ve patolojik LAP varlığı lezyonların tipi, boyutu ve lokalizasyonundan haberi olmayan iki radyolog tarafından değerlendirildi. Bulgular: Lezyon boyutları BT'de 7-110 (25.82) mm ve MG'de 6-92 (24.97) mm arasında değişmekteydi. BT ve MG'de kitle şekilleri ve kontürleri büyük oranda düzensiz idi. İki görüntüleme yöntemi arasında istatistiksel olarak anlamlı bir fark bulunmadı (p <0,001). Cerrahi patolojisi mevcut olan 133 hastanın 38'inde (% 28) tümörden ayrı malign ek odak saptanmış olup, MG’de lezyonların 18'i (% 47), BT’de ise 32’si (% 84) tespit edildi. Cerrahi patolojide 133 hastanın 55'inde (%41) patolojik lenfadenopati (LAP) tespit edilmiş olup MG’de 17 (% 30,1), BT’de ise 45 (% 81,9) patolojik LAP tespit edildi. Lezyonların yaklaşık % 70'inde hem BT hem de MG'de oldukça iyi görülebilirlik oranları vardı. İki gözlemci arasında, gözlemciler arası uyum anlamlıydı. Sonuç: Tomografi kullanımındaki artıştan dolayı, toraks BT’de meme dokusuna dikkat edilmesi ve meme kitlelerinin BT görüntüleme özellikleri bilinmesi meme kanserinin erken teşhisinde hayati öneme sahiptir. Anahtar Kelimeler: Bilgisayarlı tomografi; Meme kanseri; Meme tomografisi ABSTRACT Aim: The main purpose of present study was to determine the diagnostic features of breast cancer on tomography (CT) and investigating the degree of tomographic visibility of breast cancer. Methods: A total amount of 1000 breast lesions with histopathologic diagnose evaluated between may 2010 and january 2016. 604 (60.4% ) of these lesions were diagnosed as breast cancer. Of these, 161 (16.1%) patients were evaluated with chest CT. These 161 patient included to study and lesion’s diagnostic features in mammography (MG) and CT, tomographic visibility rates, presence of malignant additional focus and pathological LAP were evaluated by two specialist blinded to lesions type, size and location, independently. Results: The lesion sizes ranged from 7 to 110 (25.82) mm in the CT and from 6 to 92 (24.97) mm in the MG. Most of the mass shapes and margins were irregular on CT and MG. No statistically significant difference was found between the two imaging modalities (p < 0.001). Of the 133 patients, 38 (28%) lesions had additional focuses on surgical pathology. MG could detect 18 (47%), CT could detect of these 32 (84%), additional focus. Of the 133 patients, 55 (41%) lesions had pathological LAP on surgical pathology. MG could detect 17 (30,1%), CT could detect of these 45 (81.9%), pathological LAP. Nearly 70% of the lesion was clearly identified on both CT and MG. There were significant interobserver reliability rates between the two observers. Conclusions: Due to the increase in the use of tomography, attention to the breasts in the study area and knowledge of CT imaging features of breast masses is of vital importance in the early diagnosis of breast cancer. Keywords: Computerized tomography; Breast cancer; Breast tomography

Anahtar Kelimeler

• TOMOGRAFİ VE MAMOGRAFİNİN KARŞILAŞTIRILMASI

Kaynakça

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