Vrijednost dodatnog ultrazvučnog pregleda nakon magnetskom rezonancijom otkrivene sumnjive promjene u dojci

master's thesis

• Title (english): Value of additional ultrasound examination after MRI detection of suspicious breast lesion
• Author: Lora Grbanović
• Mentor: Maja Prutki (mentor)
• Committee member: Ivica Sjekavica (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Maja Prutki (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

CILJ: Svrha ovog rada je procjena vrijednosti dodatnog ultrazvučnog (UZV) pregleda u analizi sumnjivih lezija inicijalno otkrivenih na pregledu magnetskom rezonancijom (MR) kod bolesnica s karcinomom dojke. ----- MATERIJALI I METODE: U retrospektivno istraživanje uključeno je 25 bolesnica s karcinomom dojke kod kojih je u sklopu daljnje obrade učinjen pregled MR-om. Novootkrivena sumnjiva lezija pri MR pregledu dodatno je analizirana na ciljanom (“second-look”) UZV pregledu. Tvorbe sumnjivih karakteristika dodatno su analizirane biopsijom širokom iglom ili citološkom punkcijom radi patohistološke, odnosno citološke analize. Uspoređena je korelacija MR i UZV nalaza s obzirom na tip, veličinu i morfološke karakteristike lezije. ----- REZULTATI: MR-om su dijagnosticirane ukupno 33 nove lezije. Ultrazvučna korelacija utvrđena je u 25 lezija (75,8%). Od 25 lezija detektiranih na ultrazvuku, patohistološka ili citološka analiza je učinjena kod njih 15 (60,0%). Ukupno je otkriveno devet (36,0%) karcinoma i 16 lezija (64,0%) benignih karakteristika. Korelacija ultrazvučnog i MR nalaza bila je značajno veća za lezije koje su na MR-u kategorizirane kao tvorbe nego za zone imbibicije (p<0,05). Za fokuse nije pronađena niti jedna korelacija. Za tvorbe i zone imbibicije veličina ne utječe na uspjeh korelacije. Suspektne morfološke karakteristike lezija na MR-u (nepravilan oblik, nepravilni/spikulirani rubovi, inhomogeno nakupljanje kontrastnog sredstva) ne utječu na korelaciju, ali su dobar prediktor maligniteta. ----- ZAKLJUČAK: Dodatni, ciljani UZV nakon MR-om otkrivene sumnjive lezije odlična je metoda za evaluaciju lezija. Koristan je pri donošenju odluka o daljnjem dijagnostičkom ili terapijskom postupku. Tip lezije utječe na uspjeh ultrazvučne korelacije, za razliku od veličine lezije i suspektnih morfoloških karakteristika na MR-u.

Abstract (english)

OBJECTIVE: The purpose of this study was to evaluate the clinical utility of a targeted ultrasound examination in the analysis of suspicious breast lesions detected initially on MRI. ----- MATERIALS AND METHODS: This retrospective study was conducted analysing the radiology reports of 25 patients with biopsy-proven breast cancer. Patients underwent MRI as part of the preoperative workup. Newly detected lesions on MRI were subsequently evaluated by ultrasound. Percutaneous biopsy and cytopuncture were performed on suspicious lesions. Correlation of MR and ultrasound findings was compared with respect to the lesion type, size and morphological characteristics. ----- RESULTS: A total of 33 new lesions were detected on MRI. Ultrasound correlation was made in 25 lesions (75,8%). Out of 25 lesions detected on ultrasound, 15 underwent biopsy or cytopuncture. 9 lesions (36,0%) were pathohistologically confirmed as malignant and 16 (64,0%) had benign characteristics. Correlation rate of MR and ultrasound findings was significantly higher in mass lesions (p<0,05). No correlation was found for focal lesions. Size of other lesions did not affect correlation rate. MRI-detected suspicious morphological features (irregular shape, non-circumscribed margin, heterogenous/rim/clumped enhancement pattern) did not influence correlation, but were shown to be a good predictor of malignancy. ----- CONCLUSION: Targeted ultrasound is an excellent diagnostic method for detection as well as evaluation of lesions detected initially on MRI examination. It is a valuable aid in clinical decision making. Lesion type affects the correlation rate of MR and ultrasound findings, unlike the lesion size and suspicious MRI morphological features. Usage of targeted ultrasound can significantly reduce the number of unnecessary biopsies.

• Keywords: karcinom dojke; ciljani ultrazvuk; dodatni ultrazvuk; second-look ultrazvuk; MR dojke
• Keywords (english): breast cancer; targeted ultrasound; second-look ultrasound; breast MRI
• Language: croatian
• URN:NBN: urn:nbn:hr:105:490150
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-03 08:45:19