Patolojik Meme Başı Akıntısı Olan Hastalarda Galaktografi, Ultrasonografi ve Kontrastlı Manyetik Rezonans Görüntüleme Bulgularının Patoloji Sonuçları ile Karşılaştırılması

Yıl 2024, , 191 - 201, 30.06.2024

Serap Doğan , Emel Durmuş , Figen Öztürk

https://doi.org/10.31832/smj.1430107

Öz

Amaç: Bu çalışmanın amacı patolojik meme başı akıntısı (PMA) olan hastalarda galaktografi, ultrasonografi (US) ve kontrastlı manyetik rezonans görüntüleme (MRG) bulgularını patoloji sonuçlarıyla karşılaştırarak görüntüleme yöntemlerinin lezyon tespit oranlarını değerlendirmektir.
Gereç ve Yöntem: PMA ile başvuran 52 kadın hasta (yaş aralığı 18–79 yıl; ort. 49,12 yıl) çalışmaya dahil edildi. Hastaların radyolojik görüntüleme ve patoloji sonuçları retrospektif olarak değerlendirildi. Galaktografi, US ve MRG'nin lezyon tespit oranları değerlendirildi. Galaktografi bulguları modifiye Galaktogram Görüntü Sınıflandırma Sistemine (GICS) göre değerlendirildi ve patoloji sonuçlarıyla karşılaştırıldı.
Bulgular: 48 hastaya galaktografi uygulandı. 48 hastanın 45'inde (%93,8) galaktografide PMA’na neden olan lezyon saptandı. Hastaların tamamına meme US uygulandı. Hastaların 48'inde (%92,3) US'de neden olan lezyon tespit edildi. 52 hastanın 33'üne MRG çekildi ve 30 hastada (%90,9) lezyon saptandı. Galaktografi, US ve MRG bulgularının lezyon tespit oranları benzerdi.
48 hastanın (%92,3) patoloji sonucu benign, 3 hastanın (%5,8) sonucu malign idi. 1 hastada (%2) yapılan patolojik incelemede lezyona rastlanmadı. Galaktografi, US ve MRG'nin duyarlılığı sırasıyla %93,6, %92,2 ve %90,6 idi. Lezyon tespitine ilişkin görüntüleme yöntemlerinin ikili ve üçlü kombinasyonlarında duyarlılık %100 olarak bulunmuştur.
Modifiye GICS skorları ile patoloji sonuçları arasında anlamlı ilişki bulunamadı.
Sonuç: PMA olan hastalarda lezyon tespitinde Galaktografi, US ve MRG'nin duyarlılıkları yüksektir. Görüntüleme yöntemleri ikili ve üçlü kombinasyonlar halinde kullanıldığında lezyon tespit oranları artabilmektedir.

Anahtar Kelimeler

Meme başı akıntısı, Meme Manyetik Rezonans Görüntüleme, Galaktografi, Ultrasonografi

Comparison of Galactography, Ultrasonography and Contrast Enhanced Magnetic Resonance Imaging Findings with Pathology Results in Patients with Pathologic Nipple Discharge

Öz

Objective: The purpose of this study was to evaluate the lesion detection rates of imaging methods by comparing galactography, ultrasonography (US) and contrast enhanced-magnetic resonance imaging (CE-MRI) findings with pathology results in patients with pathologic nipple discharge (PND).
Materials and Methods: Fifty-two female patients (age range, 18–79 years; mean age, 49,12 years) with PND were included the study. Radiologic imaging and pathology results of patients were evaluated retrospectively. The lesion detection rates of galactography, US and CE-MRI were evaluated. Galactography findings were evaluated according to modified Galactogram Image Classification System (GICS) and compared with the pathology results.
Results: Galactography was applied in 48 patients. While in 45 (93.8%) of 48 patients lesion that causes PND was found on galactography. All of the patients had breast US. In 48 (92.3%) patients, causing lesion was found on US. CE-MRI was performed in 33 of 52 patients, and lesion was found in 30 patients (90.9%). Lesion detection rates of galactography, US and CE-MRI findings were similar.
Pathology results of 48 patients (92.3%) were benign, and the results of 3 patients (5.8%) were malignant. The result of 1 patient (2%), there was no lesion on pathologic examination. The sensitivity of galactography, US and CE-MRI were 93.6%, 92.2% and 90.6%, respectively. In the double and triple combinations of imaging methods regarding the lesion detection, sensitivity was found as 100%.
There was no significant relationship between modified GICS scores and pathology results.
Conclusion: Galactography, US and CE-MRI have high sensitivity for lesion detection in patients with PND. When galactography, US and CE-MRI findings are used in double and triple combinations, lesion detection rates could be increase.

Anahtar Kelimeler

Nipple discharge, Breast Magnetic Resonance Imaging, Galactography, Ultrasonography

Kaynakça

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