超声对乳腺恶性肿瘤的诊断完美课课件.ppt

1、超声对乳腺恶性肿瘤的诊断Ultrasonic Diagnosis of Breast Malignant Tumors乳腺恶性肿瘤的超声诊断乳腺恶性肿瘤的超声诊断昆明医学院附属昆华医院昆明医学院附属昆华医院超声科超声科 尹欣尹欣v Breast cancer is the first leading cause of death for women all over the world.v In the United States more than 8%women will suffer this disease during their life time.Sonographically,

2、the breast is divided into three layers between the skin and the chest wall.在声像图中，从皮肤至胸壁可将乳腺组织可分为在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。层。These layers include:vSubcutaneous layer 皮下组织层皮下组织层vMammary layer 腺体层腺体层vRetromammary layer 乳腺后层乳腺后层Anatomy of the Breast 乳腺的解剖乳腺的解剖 Subcutaneous layer Retromammary layer compos

3、ed of Fat and Connective tissueParenchymal Patterns The appearance of the glandular elements of the breast vary remarkably from woman to woman and vary within the same woman depending on her stage in life.女性乳腺的图像在个体间有很女性乳腺的图像在个体间有很 大的差异性，即使是同一人在大的差异性，即使是同一人在 不同阶段乳腺的图像也不同不同阶段乳腺的图像也不同 Young Female Fib

4、rous elements predominate and reflects a dense echogenic of tissue青春期女性乳腺纤维组织较多因而腺体回声细密Pregnant Female The breast proliferate remarkably in both density and volume 妊娠期女性乳腺显著增生Elder FemaleThe breast tissue becomes progressively replaced with fat老年期乳腺逐渐脂肪化How to Scan The breast is divided into four qu

5、adrant:Upper Outer Quadrant(UOQ),Upper Inner Quadrant(UIQ),Lower Outer Quadrant(LOQ),Lower Inner Quadrant(LIQ),Check these four quadrant in a clockwise direction and then scan nipple(乳头乳头)and oxter（腋下）（腋下）Sonographic Characteristics of Breast Malignant Tumors乳腺恶性肿块的超声表现乳腺恶性肿块的超声表现CancerCrab螃蟹螃蟹癌症巨蟹座

6、CancervIrregular,spiculated,or angulated border 不规则不规则,毛刺状毛刺状,或成角的边界或成角的边界Crab螃蟹Cancroid 蟹足状的Breast cancer with Irregular border边界不规则的乳腺癌Breast CancervMicrocalcifications 微钙化点微钙化点Small,hyperechoic spots without acoustic shadowing细小，高回声的光点，不伴后方声影细小，高回声的光点，不伴后方声影Benign CalcificationEggshell Calcificat

7、ion 蛋壳样钙化蛋壳样钙化Sonographic Characteristics of Breast Malignant Tumors乳腺恶性肿块的超声表现Lower Outer Quadrant(LOQ),Taller than wide 纵/横比1Abundant in blood flow signalsMicrocalcifications 微钙化点Subcutaneous layer 皮下组织层FibroadenomaHow to ScanIrregular,spiculated,or angulated borderThe breast proliferate remarkabl

8、y in both density and volumeBreast cancer with Irregular border边界不规则的乳腺癌Sonographically,the breast is divided into three layers between the skin and the chest wall.Retromammary layer 乳腺后层Mammary layer 腺体层Taller than wideCharacteristics of Malignant CalcificationsLower Inner Quadrant(LIQ),细小钙化，1mm。在声

9、像图中，从皮肤至胸壁可将乳腺组织可分为3层。Wider than tall 纵横比1Characteristics of Malignant Calcifications 1.Concentrated in one area,usually in the tumor.2.Microcalcifications,1mm.3.Over 5 microcalcifications in 1 cm 1.集中于一处，多位于肿块内。集中于一处，多位于肿块内。2.细小钙化，细小钙化，1vParallel wider than tall long axis parallel to skinvNOT paral

10、lel taller than wide long axis perpendicular to skin Taller than widev The growth of malignant tumors are often infiltrate surrounding structures and resulting the aspect ratio is 1 恶性肿瘤的生长常常浸润正常结构而导致前后径增大，故纵横比常恶性肿瘤的生长常常浸润正常结构而导致前后径增大，故纵横比常1。CancervAbundant in blood flow signals 血流信号丰富血流信号丰富 Benign

11、tumor with rich blood flow signals管中窥豹只一斑，叶落难断已秋天。管中窥豹只一斑，叶落难断已秋天。是峰是岭横侧看，超脱物外也非仙！是峰是岭横侧看，超脱物外也非仙！Characteristics of Benign Tumorsv Oval or round 圆形或卵圆形圆形或卵圆形v Smooth,sharp border 边界光滑，清楚边界光滑，清楚v Uniform echogenicity 回声均匀回声均匀v Wider than tall 纵横比纵横比 1 恶性肿瘤的生长常常浸润正常结构而导致前后径增大，故纵横比常1。Lower Outer Quadr

12、ant(LOQ),Sonographically,the breast is divided into three layers between the skin and the chest wall.在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Retromammary layerBreast cancer with Irregular border边界不规则的乳腺癌Over 5 microcalcifications in 1 cmParenchymal PatternsLower Outer Quadrant(LOQ),Wider than tall 纵横比1Lower Outer Q

13、uadrant(LOQ),Abundant in blood flow signalsEggshell CalcificationWider than tall 纵横比1Ultrasonic Diagnosis of Breast Malignant Tumors乳腺恶性肿瘤的超声诊断Elder Female不规则,毛刺状,或成角的边界Breast cancer with Irregular border边界不规则的乳腺癌Irregular,spiculated,or angulated border不规则,毛刺状,或成角的边界Over 5 microcalcifications in 1 c

14、m是峰是岭横侧看，超脱物外也非仙！细小钙化，1mm。管中窥豹只一斑，叶落难断已秋天。每平方厘米微小钙化数 5个Lower Outer Quadrant(LOQ),How to ScanSonographically,the breast is divided into three layers between the skin and the chest wall.Lower Outer Quadrant(LOQ),stage in life.Parenchymal PatternsAbundant in blood flow signalsOval or round 圆形或卵圆形Lower

15、Outer Quadrant(LOQ),超声对乳腺恶性肿瘤的诊断实用医技杂志2006.Irregular borderLower Outer Quadrant(LOQ),Subcutaneous layer 皮下组织层composed ofwide long axis在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Smooth,sharp border 边界光滑，清楚depending on herIrregular borderLower Outer Quadrant(LOQ),Characteristics of Benign TumorsOval or round 圆形或卵圆形Small

16、,hyperechoic spots without acoustic shadowingWider than tall 纵横比1Subcutaneous layerSonographically,the breast is divided into three layers between the skin and the chest wall.Mammary layer 腺体层Sonographically,the breast is divided into three layers between the skin and the chest wall.在声像图中，从皮肤至胸壁可将乳腺

17、组织可分为3层。Sonographically,the breast is divided into three layers between the skin and the chest wall.NOT parallel taller thanUpper Outer Quadrant(UOQ),在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Pregnant FemaleLower Outer Quadrant(LOQ),每平方厘米微小钙化数 5个Parenchymal PatternsUpper Inner Quadrant(UIQ),Wider than tall 纵横比1Abunda

18、nt in blood flow signalsAbundant in blood flow signalsParallel wider than tall long axis parallel to skinIn the United States more than 8%women will suffer this disease during their life time.The breast tissue becomes progressively replaced with fatParenchymal PatternsOver 5 microcalcifications in 1

19、 cm在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。细小钙化，1mm。Abundant in blood flow signals细小钙化，1mm。wide long axisIrregular border不同阶段乳腺的图像也不同How to ScanPregnant Female每平方厘米微小钙化数 5个在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Lower Outer Quadrant(LOQ),Characteristics of Benign TumorsLower Outer Quadrant(LOQ),Characteristics of Malignant Calcifications在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Company LogoSonographic Characteristics of Breast Malignant Tumors乳腺恶性肿块的超声表现Smooth,sharp border 边界光滑，清楚In the United States more than 8%women will suffer this disease during their life time.Characteristics of Benign TumorsSubcutaneous layer谢谢观看！谢谢观看！