Jinekolojik patolojilerin karakterizasyonunda dinamik MRG tetkiki- say?sal ??karma program? kullan?m?n?n tan?sal etkinli?i

摘要

?zet Ama?. Bu ?al??man?n amac? pelvik kitle ve neoplaziler gibi jinekoloik patolojilerde LAVA sekans?n? i?eren dinamik pelvik MRG tetkikinin say?sal ??karma y?ntemi ile birlikte kullan?m?n?n tan?sal etkinli?ini ara?t?rmakt?r. Y?ntem. Klini?imizde Kad?n Hastal?klar? ve Do?um Klini?i taraf?ndan refere edilmi? jinekolojik patolojisi bulunan 62 olgu (18-75 ya? aras?) Dinamik MRG tetkiki ile de?erlendirildi. Olgularda konvansiyonel MRG sekanslar? ile birlikte kontrastl? inceleme olarak 10 mg gadolinyumlu kontrast madde uygulamas? sonras? GE sekans ile ard???k 4 faz aksiel LAVA serisi al?narak kitlenin kontrastlanma paterni belirlendi. Bulgular. 20 olguda histopatolojik de?erlendirme ve 25 olguda tipik radyolojik g?rünüm ve klinik takip ile tan?ya ula??ld?. Olgular LAVA sekans?ndaki kontrastlanma paternlerine g?re benign (düz, ?izgisel) ve malign (nodüler heterojen) ayr?ca erken-ge? ve yo?un- k?smi paternlerde de?erlendirildi. ?statistiki de?erlendirme ile tetkik edilen 45 olguda LAVA sekans?n?n malign benign ayr?m?nda; sensitivitesi %95, spesifitesi %100 ve pozitif prediktif de?er %100, negatif prediktif de?er %92 hesapland?. Sonu?. Karaci?er kitleleri i?in geli?tirilen LAVA sekans? jinekolojik patolojilerin karakterizasyonu amac? ile de kullan?labilecek h?zl?, etkin ve güvenilir bir y?ntem olarak say?sal ??karma y?ntemi ile birlikte klasik MRG sekanslara eklenebilir. Anahtar s?zcükler. MRG, pelvik kitle, endometrium ca, serviks ca Abstract Aim. The purpose of this study is to investigate the diagnostic efficiency of the dynamic pelvic MRI examination which includes LAVA sequence with digital substraction technique on the patients with gynecologic pathology. Methods. The dynamic MRI of 62 patients (between 18-75 ages) who were examined in gynecology clinic because of pelvic mass was evaluated in our clinic prospectively. We examined the pattern of contrast enhancement of the mass by conventional MRI sequence in addition consecutive 4 phase LAVA series after 10 mg gadolinium contrast matter was perfomed. Results. We diagnosed 25 patients with typical radiologic appearence and clinically follow up and 20 patients with histopathological examination. The patients were considered as benign (straight,linear) or malign (nodular,heterogenous) and also early-late and dense-partial according to the pattern of contrast enhancement in LAVA sequence. The sensitivity value of the differentiation of benign /malign lesions with LAVA sequence was estimated as % 95 and also the other values specifity %100, positive predictive value %100 and negative predictive value %92 by the statistical evaluation. Conclusion. LAVA sequence which was developed for characterization of liver mass can be supplement to the conventional MRI sequence with digital substraction technique as a rapid and efficient diagnostic method for gynecologic pathologies characterization.