Meme patolojilerinde aksiller lenf nodu ayırıcı tanısında difüzyon manyetik rezonans görüntülemenin tanıya katkısı
Küçük Resim Yok
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda rutin meme görüntülemesi yapılan olgularda rutin incelemeye ek olarak kontrast madde gerektirmeyen difüzyon ağırlıklı görüntüleme yapılarak aksiller lenf nodlarında ayırıcı tanıya olan katkısını değerlendirmeyi amaçladık. Nisan 2010 ? Temmuz 2011 tarihleri arasında, meme manyetik rezonans incelemesi için manyetik rezonans görüntüleme ünitesine başvuran ve rutin meme manyetik rezonans inceleme yanında difüzyon ağırlıklı inceleme yapılan 71 erişkin kadın hasta çalışmamıza dahil edildi. Meme lezyonu malign olana hastalarda lenf nodu için histopatolojik tanıya gidildi. Meme lezyonu benign olan hastalarda ise klinik takip ile aksiller lenf nodu benign olarak değerlendirildi. Difüzyon ağırlıklı görüntüler 30 sn.?de elde olundu. Manyetik rezonans cihazının konsolunda, özel yazılım aracılığıyla görünür difüzyon katsayısı otomatik olarak ölçülerek harita görüntüleri hazırlandı. Değerlendirmede aksilladaki en büyük lenf nodu seçilerek konvansiyonel sekanslardaki bulguları kaydedildi. T2 ağırlıklı görüntülemede uzun eksen ve kısa eksen çapı ölçüldü ve uzun eksen/kısa eksen oranı hesaplandı. Bunun yanı sıra difüzyon ağırlıklı görüntülemedeki görünümü ve görünür difüzyon katsayısı haritasından ölçülen değerleri not edildi. Konvansiyonel meme manyetik rezonans incelemede saptanan lenfadenopatilerin difüzyon kısıtlanması varlığı araştırıldı. Kantitatif değerlendirme amacı ile görünür difüzyon katsayı haritalarında ilgi alanı kullanarak ölçüm yapıldı. Metastatik lenf nodlarının görünür difüzyon katsayısı reaktif lenf nodlarından anlamlı derecede düşük olarak bulunmuştur. Reaktif lenf nodlarında görünür difüzyon katsayısı ortalama 2,21x10-3mm2/sn, metastatik lenf nodlarında ise görünür difüzyon katsayısı ortalama 1,39x10-3mm2/sn olarak saptanmıştır. Tüm lenf nodlarının görünür difüzyon katsayısı `Receiver Operating Characteric? analizi ile 1,6 x10-3 mm²/sn sınır olarak alındığında %55,9 sensitivite ve %81,1 spesifite ile reaktif metastatik ayrımı yapabilmektedir (p<0.001). Difüzyon ağırlıklı görüntüleme tek başına ayırıcı tanı yapamamasına rağmen, konvansiyonel meme manyetik rezonanans incelemeye tamamlayıcı olarak kullanılabilir. Anahtar kelimeler: Aksiller lenf nodu, Difüzyon Manyetik Rezonans Görüntüleme, Görünür difüzyon katsayısı
In this study, we aimed to evaluate the contribution of the diffusion weighted imaging that does not require contrast agent on differential diagnosis of axillary lymph nodes in addition to the routine examination of breast magnetic resonance imaging. Between April 2010 ? July 2011, 71 adult women who applied to our unit for breast magnetic resonance invastigation and were examined by routine breast examination as well as diffusion weighted imaging, were included in the study. Histopatological diagnoses for lymph nodes were made in patients who had malign breast lessions. Axillary lmph nodes evaluated benign at patients who had malign breast lessions Diffusion weighted images were obtained in 30 sec. At the console of magnetic resonance imaging device, the map images were automatically created by measuring the Apperent Diffusion Coefficient values through custom software. In the evaluation process, conventional sequences? findings were recorded picking the largest lymph nodes in axilla. Long axis and short axis diameter were measured on T2 weighted images and calculated long axis and short axis rate.Also apperance of Diffusion weighted images and values measured from the Apperent Diffusion Coefficient map were noted. lymphadenopathy?s the presence of diffusion restriction found on conventional breast magnetic resonance imaging were investigated. With the aim of quantitative evaluation, measurement circle was used to measure on the Apperent Diffusion Coefficient maps. Apperent Diffusion Coefficient value of metastatic lymph nodes was found to be significantly lower than of the benign lesions. The mean Apperent Diffusion Coefficient value has been determined as 2,21x10-3mm2/sn, for reactive lymph nodes benign lesions and as 1,39x10-3mm2/sn for metastatic lymph nodes. If the limit was defined as 1,6 x10-3mm2/sn with Receiver Operating Characteric analysis for Apperent Diffusion Coefficient values of all lymph nodes, the distinction between reactive and metastatic can be made with %55,9 sensitivity and %81,1 specificity (p <0,001). Although diffusion-weighted imaging can not make differential diagnosis alone, it can be used to complement conventional breast magnetic resonance investigation. Key words: Axillary lymph node, Diffusion Magnetic Resonance Imaging, Apperent Diffusion Coefficient
In this study, we aimed to evaluate the contribution of the diffusion weighted imaging that does not require contrast agent on differential diagnosis of axillary lymph nodes in addition to the routine examination of breast magnetic resonance imaging. Between April 2010 ? July 2011, 71 adult women who applied to our unit for breast magnetic resonance invastigation and were examined by routine breast examination as well as diffusion weighted imaging, were included in the study. Histopatological diagnoses for lymph nodes were made in patients who had malign breast lessions. Axillary lmph nodes evaluated benign at patients who had malign breast lessions Diffusion weighted images were obtained in 30 sec. At the console of magnetic resonance imaging device, the map images were automatically created by measuring the Apperent Diffusion Coefficient values through custom software. In the evaluation process, conventional sequences? findings were recorded picking the largest lymph nodes in axilla. Long axis and short axis diameter were measured on T2 weighted images and calculated long axis and short axis rate.Also apperance of Diffusion weighted images and values measured from the Apperent Diffusion Coefficient map were noted. lymphadenopathy?s the presence of diffusion restriction found on conventional breast magnetic resonance imaging were investigated. With the aim of quantitative evaluation, measurement circle was used to measure on the Apperent Diffusion Coefficient maps. Apperent Diffusion Coefficient value of metastatic lymph nodes was found to be significantly lower than of the benign lesions. The mean Apperent Diffusion Coefficient value has been determined as 2,21x10-3mm2/sn, for reactive lymph nodes benign lesions and as 1,39x10-3mm2/sn for metastatic lymph nodes. If the limit was defined as 1,6 x10-3mm2/sn with Receiver Operating Characteric analysis for Apperent Diffusion Coefficient values of all lymph nodes, the distinction between reactive and metastatic can be made with %55,9 sensitivity and %81,1 specificity (p <0,001). Although diffusion-weighted imaging can not make differential diagnosis alone, it can be used to complement conventional breast magnetic resonance investigation. Key words: Axillary lymph node, Diffusion Magnetic Resonance Imaging, Apperent Diffusion Coefficient
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine
