Mamografide Mikrokalsifikasyon Tespit Edilen Hastalarda Kontrastlı Spektral Mamografi ile Dinamik Meme MRG’nin Etkinliğinin Karşılaştırılması: Tek Merkez Deneyimi

Yıl 2021, , 415 - 420, 25.12.2021

Kamber Göksu , Ahmet Vural

https://doi.org/10.29058/mjwbs.960285

Öz

Amaç: Bu çalışmanın amacı, mammografi tetkiki ile mikrokalsifikasyon tespit edilen hastalarda kontrastlı
spektral mamografi (KSM) ile meme manyetik rezonans görüntülemenin (MRG) tanısal performansını
karşılaştırmaktır.
Gereç ve Yöntemler: Kasım 2014 - Mayıs 2019 tarihleri arasında mammografi ile mikrokalsifikasyon
saptanan, daha sonra hem KSM hem Meme MRG incelemesi yapılan 75 kadın (ort. Yaş, 56,3 yaş ±
10,6) çalışmaya dahil edildi. Hastaların çalışmaya dahil edilebilme kriteri olarak, histopatolojik olarak
tanı almış olması ve hem KSM hem Meme MRG tetkikinin yapılmış olması koşulu arandı. KSM ve
Meme MRG için patolojik kontrastlanma varlığı histopatolojik tanı ile birlikte Fisher-Freeman-Halton
Exact testi kullanılarak istatistiksel olarak karşılaştırıldı.
Bulgular: Mikrokalsifikasyon saptanmış 75 hastaya KSM ve Meme MRG incelemeleri yapıldı. Bu hastaların
Meme MRG incelemelerinde 47 olguda patolojik kontrast tutulumu tespit edildi. KSM incelemesi
ile 49 hastada mikrokalsifikasyon bölgesinde kontrast tutulumu mevcut idi. Her iki tetkik ile kontrast
tutulumu görülen 47 hasta ortak idi. Biyopsi sonucu benign gelenlerin kontrast tutulum oranları KSM ve
MRG için aynı idi (%48,9), malign olanların kontrast tutulum oranları KSM için %96 iken MRG için %88,
premalign olanların kontrast tutulumu KSM ve Meme MRG için %60 olarak bulundu. Biyopsi sonuçlarına
göre lezyonların kontrast tutulumları karşılaştırıldığında KSM ve Meme MRG için istatistiksel olarak
anlamlı bir farklılık saptanmadı.
Sonuç: KSM, daha az arka plan kontrastlanması göstermekte olup meme kanseri tespitinde Meme
MRG ile benzer duyarlılığa sahiptir. KSM, Meme MRG’ye göre daha kolay erişilebilir bir alternatif olup
işlem süresi anlamlı derecede daha kısadır. Bu nedenlerle meme kanseri tespiti ve evrelemesinde
önemli bir rol üstlenebilecek potansiyele sahiptir.

Anahtar Kelimeler

Mamografi, Mikrokalsifikasyon, Manyetik rezonans görüntüleme, Kontrastlı spektral mamografi

Comparison of the Effectiveness of Contrast-Enhanced Spectral Mammography and Dynamic Breast MRI in Patients with Microcalcifications Detected in Mammography: A Single Center Experience

Öz

Aim: The aim of this study is to compare the diagnostic performance of contrast-enhanced spectral
mammography (CESM) and breast magnetic resonance imaging (MRI) in patients with microcalcification
detected by mammography.
Material and Methods: A seventy-five women (mean age, 56.3 years ± 10.6 years) who were found to have microcalcification by
mammography between November 2014 and May 2019, and who had both CESM and Breast MRI examinations later were included in the
study. As the criteria for inclusion in the study, the condition that the patients were diagnosed histopathologically and that both CESM and
Breast MRI were performed were sought. The presence of pathological enhancement for CESM and Breast MRI was compared statistically
using the Fisher-Freeman-Halton Exact test together with histopathological diagnosis.
Results: CESM and Breast MRI examinations were performed in 75 patients with microcalcifications. Pathological contrast enhancement
was detected in 47 cases in breast MRI examinations of these patients. With CESM examination, 49 patients had contrast enhancement in
the microcalcification region. Forty-seven patients with contrast enhancement with both examinations were common. Contrast enhancement
rates of those who were found benign as a result of the biopsy were the same for CESM and MRI (48.9%). Contrast enhancement rates of
malignant ones were 96% for CESM, 88% for MRI, and 60% for CESM and Breast MRI for premalignant lesions. When contrast enhancement
of the lesions was compared according to the biopsy results, no statistically significant difference was found for CESM and Breast MRI.
Conclusion: CESM shows less background enhancement and has a similar sensitivity to breast MRI in detecting breast cancer. CESM is
an easily accessible alternative to Breast MRI and the procedure time is significantly shorter. For these reasons, it has the potential to play
an important role in breast cancer detection and staging.

Anahtar Kelimeler

Mammography, Microcalcification, Magnetic Resonance Imaging, Contrast-enhanced spectral mammography

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