1、超声对乳腺恶性肿瘤的诊断（优选）超声对乳腺恶性肿瘤的诊断（优选）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
2、their life time.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
3、 layer Retromammary layer composed 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
4、也不同不同阶段乳腺的图像也不同 Young Female Fibrous 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昆明医学院附属昆华医院超声科 尹欣Uniform echogenicity 回声均匀Microcalcifications 微钙化点Check these four quadrant in a clockwise direction and then scan nipple(乳头)and oxter（腋下）Eggshell CalcificationHow t
5、o ScanSubcutaneous layerThe 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1。Breast cancer with Irregular border边界不规则的乳腺癌不规则,毛刺状,或成角的边界Small,hyperechoic spots without acoustic shadowingLower Inner Quadrant(LIQ),
6、Young FemaleFibrous elements predominate and reflects a dense echogenic of tissuestage in life.Benign CalcificationTaller than wide 纵/横比1女性乳腺的图像在个体间有很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 w
7、ith fat老年期乳腺逐渐脂肪化How to Scan The breast is divided into four quadrant: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 B
8、reast 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女性乳腺的图像在个体间有很Smooth,sharp border 边界光滑，清楚不规则,毛刺状,或成角的边界The appearance of the glandular elements of th
9、e breast vary remarkably from woman to woman and vary within the same womanTaller than wideWider than tall 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。细小，高回声的光点，不伴后方声影不同阶段乳腺的图像也不同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Beni
10、gn CalcificationEggshell Calcification 蛋壳样钙化蛋壳样钙化Company LogoCharacteristics 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 paralle
11、l to skinvNOT parallel 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
12、流信号丰富血流信号丰富 Benign 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！Subcutaneous layer Retromammary layerBenign Calcification乳腺的解剖Benign Calcification不规则,毛刺状,或成角的边界不规则,毛刺状,或成角的边界细小，高回声的光点，不伴后方声影Mammary layerIrregular,spiculated,or angulated borderTall
13、er than widestage in life.Elder FemaleUpper Inner Quadrant(UIQ),Sonographically,the breast is divided into three layers between the skin and the chest wall.青春期女性乳腺纤维组织较多因而腺体回声细密女性乳腺的图像在个体间有很Upper Outer Quadrant(UOQ),Irregular,spiculated,or angulated borderMammary layerIrregular,spiculated,or angulat
14、ed borderSmall,hyperechoic spots without acoustic shadowing不规则,毛刺状,或成角的边界Sonographically,the breast is divided into three layers between the skin and the chest wall.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，
15、故纵横比常1。Retromammary layerFibrous elements predominate and reflects a dense echogenic of tissue不同阶段乳腺的图像也不同Breast CancerConcentrated in one area,usually in the tumor.The breast tissue becomes progressively replaced with fat不规则,毛刺状,或成角的边界Benign CalcificationTaller than wide 纵/横比1Company LogoUniform echogenicity 回声均匀乳腺的解剖Taller than wide 纵/横比1Elder FemaleTaller than wideCharacteristics 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1Fibroadenoma纤维腺瘤纤维腺瘤
