Mogućnosti ultrazvuka visoke rezolucije u prikazu i nadzoru biopsija mamografski suspektnih nakupina mikrokalcifikacija [Role of the high resolution ultrasound in the detection and biopsy guidance of mammographically suspicious microcalcification clusters]

Čikara, Igor (2012) Mogućnosti ultrazvuka visoke rezolucije u prikazu i nadzoru biopsija mamografski suspektnih nakupina mikrokalcifikacija [Role of the high resolution ultrasound in the detection and biopsy guidance of mammographically suspicious microcalcification clusters]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

PURPOSE: To determine role of the US in identifying and localizing breast microcalcifications with and without mass, and to evaluate reliability of US guided core biopsy. To evaluate the role of color and power Doppler with spectral vaweform analysis and measurement resistance index in breast lesions with and withouh microcalcifications. ----- MATERIAL AND METHODS: 140 women were examined with US including color, power and spectral vaweform analysis. 70 women had a MMG visible microcalcifications clusters with associated mass and 70 women had microcalcifications only. All underwent core biopsy under US guidance. Clinical, morphological and pathologic findings were retrospectively rewieved. ----- RESULTS: 91% women with microcalcifications and soft tissue mass had positive US examination. 74% women with only microcalcifications cluster had positive US examination. All lesions underwent core biopsy under US guidance. 46% women with microcalcifications and 72% women with microcalcifications and mass have positive color and power Doppler examination. With Color and power Doppler, and with spectral vaweform analysis (SFA) we measured vascular characteristic of lesion. Measurement of resistence index is also done, and with SFA we distinguish vascularizations from artifacts. ----- CONCLUSIONS: US is an accurate method to identify breast lesions with microcalcifications, and also an effective method for tissue-sampling of breast microcalcifications. US guided biopsy can be used as alternative method to stereotactic MMG biopsy. US Color and power Doppler with spectral vaweform analisis (SFA) are sensitive indicator of vascularization inside lesions, but for now have not a significant role in diagnosis of lesions with microcalcification.

Abstract in Croatian

CILJ RADA: Prikazati mogućnost UZV u dijagnostici i nadzoru biopsija lezija dojke koje sadrže mikrokalcifikate. Istražiti ulogu obojenog i power doplera te spektralne frekvencijske analize u dijagnostici lezija dojki koje sadrže mikrokalcifikate. ----- BOLESNICI I METODE: Analizirano je 140 žena. 70 sa mamografski vidljivim mikrokalcifikatima uz mekotkivnu tvorbu i 70 sa mamografski vidljivim mikrokalcifikatima bez tvorbe. Sve lezije su analizirane obojenim i power doplerom, a spektralnom analizom kvantificiran je protok i mjereni indeksi otpora. Kod svih UZV vidljivih lezija učinjene su biopsije širokom iglom pod nadzorom UZV. ----- REZULTATI: Ultrazvukom smo prikazali mikrokalcifikate kod 91% bolesnica s MKC i mekotkivnom lezijom te kod 74% bolesnica samo s MKC, a sve prikazane lezije smo uspješno bioptirali širokom iglom pod kontrolom UZV. Doplerom smo prikazali protok u 46% bolesnica s MKC te u 72% bolesnica kod promjena s MKC i mekotkivnom lezijom. Obojenim i power doplerom uz spektralnu frekvencijsku analizu smo prikazali karakteristike protoka u lezijama, mjerili indekse otpora i razlikovali protoke od artefakata. ----- ZAKLJUČAK: Ultrazvuk se pokazao kao točna metoda za prikaz nakupina mikrokalcifikata i pridruženih lezija. Ultrazvuk je pouzdana i jednostavna metoda za nadzor biopsija širokom iglom i alternativa je kompliciranijoj i skupljoj stereotaksijskoj biopsiji pod kontrolom MMG. Obojeni i power dopler i SFA s kvantifikacijom protoka su dodatne pomoćne metode pregleda ultrazvukom koje za sada imaju ograničenu primjenu.

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