Objective: The aim of this study was to understand the role of ultrasonographic elastography method in the differentiation of breast masses and to assess its contribution to classic ultrasonographic evaluation. Materials and Methods:In this retrospective study, 76 breast masses in 76 patients were firstly evaluated by conventional ultrasonography (U.S.) and scored according to breast imaging report and data systems (BIRADS) and then evaluated with the Elastographic method during the same session between January and December 2013 in our hospital's Radiology Department. Findings were compared with pathological results. In statistical evaluation of the data, independent sample t tests were used for variables between groups. Results:The mean strain ratio of benign masses was 2.48±1.605 and strain score was 2.307±1.327. The mean strain ratio of malignant masses was 5.546±1.434 and strain score was 4.458±0.721. The most frequent benign masses were fibroadenoma and fibrocystic lesions. The most common malignant lesion was invasive ductal carcinoma. When the cut-off value for strain ratio was accepted as 4.009 in receiver operating curve (ROC) analysis for the differential diagnosis of malignant breast masses, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated as 83.8%, 76.9%, 62.3%, and 90.7%, respectively. When the limit value of strain patterns was accepted as scores 4 and 5, the sensitivity, specificity, PPV, and NPV were calculated as 42.7%, 94.2%, 77.2%, and 78%, respectively. When conventional ultrasonography (U.S.) findings were considered together with the elastographic strain ratios the sensitivity, specificity, PPV and NPV were 87.5%, 71.1%, 58.3% and 92.5%, respectively. Conclusion:Elastography is not a method that can replace conventional breast ultrasound for detecting breast cancer, however it may be an adjunct to conventional ultrasound by increasing its diagnostic power.

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ÖZET

Mehmet YAĞTU, Eren TURAN, Çiğdem ÖZTÜRK TURAN ÖzetAmaç: Bu çalışmada pankreas kitlelerinin, difüzyon ağırlıklı MR görüntüleme ile görünür difüzyon katsayısı (ADC) değerlerinin ölçülmesinin tanıya ve kitlelerin benign malign ayrımına katkısının değerlendirilmesi amaçlandı. Gereç ve Yöntem:Pankreas kitlesi olan 31 olgunun 31 adet kitlesine difüzyon ağırlıklı MR sekansı uygulandı. Aksiyal planda, single shot eko-planar spin eko sekansı ile her üç yönde (x, y, z), üç farklı b değerinde (b=0, b=500 ve b=1000 s/mm²) difüzyon duyarlı gradiyentler uygulanarak difüzyon ağırlıklı görüntüler ve b=500 değeri için ADC haritaları elde edildi. Verilerin istatistiksel olarak değerlendirmesi yapılırken gruplar arasındaki değişkenler için Mann-Whitney U testi kullanıldı. Bulgular:Otuz bir pankreas kitlesinin 17 tanesi benign, 14 tanesi malign özellikteydi. Benign kitlelerin sekizi psödokist, sekizi indetermine, biri kitleyi taklit eden pankreatit oluşturuyor-du. Malign kitleler ise sekizi adenokarsinom, üçü intraduktal papiller musinöz neoplazi, üçü orijini bilinmeyen malign hüc-relerden oluşmaktaydı. ADC ölçümleri sonucunda en yüksek değerler psödokistler aitti. B=500 s/mm² değerinde benign kitlelerin ortalama ADC değeri, 2.12±0.56x10 -3 mm 2 /s, malign kitlelerin ortalama 1.25±0.14x10 -3 mm 2 /s olarak ölçüldü.Sonuç: Benign lezyonların ortalama ADC değeri malign lezyonların ortalama ADC değeri ile karşılaştırıldığında; ADC ölçümlerinin pankreas kitlelerinin malign benign ayrımında anlamlı olduğu bulundu (p<0.05).Anahtar sözcükler: Görünür difüzyon katsayısı; manyetik rezonans görüntüleme; pankreas. (x, y, z) Summary Background: In this study, we aimed to evaluate the value of diffusion weighted MR imaging with the use of apparent diffusion coefficient (ADC) measurements on diagnosis and differentiation of benign and malignant pancreatic masses. Methods: Diffusion weighted MR sequence was performed to 31 masses of 31 cases. In axial plan single shoot echo-planar spin echo sequence for 3 plans