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Fibrous elements predominate and reflects a dense echogenic of tissueThe breast proliferate remarkably in both density and volumeHow to ScanBenign CalcificationPregnant FemaleConcentrated in one area,usually in th
5、e tumor.细小，高回声的光点，不伴后方声影composed of每平方厘米微小钙化数 5个Ultrasonic Diagnosis of Breast Malignant Tumors乳腺恶性肿瘤的超声诊断Microcalcifications 微钙化点Taller than wideAbundant in blood flow signalsUniform echogenicity 回声均匀Microcalcifications,1mm.在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Parallel wider than tall long axis parallel to skin
6、NOT parallel taller thanFibrous elements predominate and reflects a dense echogenic of tissue每平方厘米微小钙化数 5个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 d
7、ivided 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 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
8、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 Calcification
9、Eggshell Calcification 蛋壳样钙化蛋壳样钙化Characteristics 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 parallel talle
10、r 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Breast cancer wit
11、h Irregular border边界不规则的乳腺癌Breast cancer with Irregular border边界不规则的乳腺癌Small,hyperechoic spots without acoustic shadowingHow to ScanThe breast tissue becomes progressively replaced with fatSonographic Characteristics of Breast Malignant Tumors乳腺恶性肿块的超声表现细小钙化，1mm。Lower Outer Quadrant(LOQ),Fibrous ele
12、ments predominate and reflects a dense echogenic of tissuedepending on herFibroadenomaMicrocalcifications,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。Smooth,sharp border 边界光滑，清楚Benign or Malignant？Abundant in blood flow signalsFibrous elements predominate and reflects a dense echogenic of tissueRetromammary la
13、yer 乳腺后层Concentrated in one area,usually in the tumor.细小，高回声的光点，不伴后方声影 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！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
14、声均匀v Wider than tall 纵横比纵横比1Fibroadenoma纤维腺瘤纤维腺瘤 Benign or Malignant？Company LogoCase 1v Irregular borderv Microcalcificationsv Abundant in blood flow signalsMalignantCompany LogoIn the United States more than 8%women will suffer this disease during their life time.Fibrous elements predominate and r
15、eflects a dense echogenic of tissue在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。每平方厘米微小钙化数 5个Check these four quadrant in a clockwise direction and then scan nipple(乳头)and oxter（腋下）Benign tumor with rich blood flow signalsParallel wider than tall long axis parallel to skincomposed ofBreast cancer with Irregular border边界
16、不规则的乳腺癌Breast cancer is the first leading cause of death for women all over the world.不同阶段乳腺的图像也不同Subcutaneous layer 皮下组织层Anatomy of the BreastRetromammary layerCharacteristics of Benign Tumorsperpendicular to skinPregnant FemaleFibrous elements predominate and reflects a dense echogenic of tissueCh
17、aracteristics of Benign TumorsUniform echogenicity 回声均匀Anatomy of the Breast在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。The appearance of the glandular elements of the breast vary remarkably from woman to woman and vary within the same woman昆明医学院附属昆华医院超声科 尹欣depending on herYoung FemaleRetromammary layerRetromammary lay
18、er 乳腺后层In the United States more than 8%women will suffer this disease during their life time.perpendicular to skinThese layers include:Company LogoThe breast tissue becomes progressively replaced with fatPregnant FemalePregnant FemaleOval or round 圆形或卵圆形管中窥豹只一斑，叶落难断已秋天。The breast proliferate remark
19、ably in both density and volumeBreast cancer with Irregular border边界不规则的乳腺癌Subcutaneous layer 皮下组织层Upper Outer Quadrant(UOQ),不同阶段乳腺的图像也不同Microcalcifications,1perpendicular to skin大的差异性，即使是同一人在大的差异性，即使是同一人在Taller than wideTaller than wide 纵/横比1Pregnant FemaleBreast cancer with Irregular border边界不规则的乳
20、腺癌Fibrous elements predominate and reflects a dense echogenic of tissueRetromammary 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。Lower Outer Quadrant(LOQ),Young Femaleperpendicular to skinElder Fema
21、leFat and Connective tissue青春期女性乳腺纤维组织较多因而腺体回声细密Characteristics of Benign TumorsMammary layer 腺体层Fibrous elements predominate and reflects a dense echogenic of tissueThe breast tissue becomes progressively replaced with fatBreast cancer with Irregular border边界不规则的乳腺癌In the United States more than 8%women will suffer this disease during their life time.The breast proliferate remarkably in both density and volumeTaller than wide 纵/横比1Retromammary layer细小钙化，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。谢谢观看！谢谢观看！
