超聲對乳腺惡性腫瘤的診斷完美課課件

超聲對乳腺惡性腫瘤的診斷超聲對乳腺惡性腫瘤的診斷1UltrasonicDiagnosisofBreastMalignantTumors

乳腺惡性腫瘤的超聲診斷

昆明醫(yī)學(xué)院附屬昆華醫(yī)院

超聲科尹欣

UltrasonicDiagnosisofBreast2Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.BreastcanceristhefirstleaSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.

在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Theselayersinclude:Subcutaneouslayer皮下組織層Mammarylayer腺體層Retromammarylayer乳腺后層AnatomyoftheBreast乳腺的解剖Sonographically,thebreasSubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutaneParenchymalPatterns

Theappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomandependingonherstageinlife.

女性乳腺的圖像在個(gè)體間有很大的差異性，即使是同一人在不同階段乳腺的圖像也不同

ParenchymalPatterns

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纖維組織較多因而腺體回聲細(xì)密YoungFemaleFibrouselementsPregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺顯著增生PregnantFemaleThebreastpElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐漸脂肪化ElderFemaleThebreasttissueHowtoScanThebreastisdividedintofourquadrant

:UpperOuterQuadrant(UOQ),UpperInnerQuadrant(UIQ),LowerOuterQuadrant(LOQ),LowerInnerQuadrant(LIQ),Checkthesefourquadrantinaclockwisedirection

andthenscannipple(乳頭)andoxter（腋下）HowtoScanThebreastisdiSonographicCharacteristics

of

BreastMalignantTumors

乳腺惡性腫塊的超聲表現(xiàn)SonographicCharacteristics

oCancerCrab螃蟹癌癥巨蟹座Cancer癌癥巨蟹座CancerIrregular,spiculated,orangulatedborder

不規(guī)則,毛刺狀,或成角的邊界Crab螃蟹Cancroid蟹足狀的CancerCrab螃蟹Cancroid蟹足狀的CancerBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌

CancerBreastcancerwithIrregBreastCancerMicrocalcifications微鈣化點(diǎn)Small,hyperechoicspotswithoutacousticshadowing細(xì)小，高回聲的光點(diǎn)，不伴后方聲影BreastCancerMicrocalcificatioBenignCalcificationEggshellCalcification

蛋殼樣鈣化BenignCalcificationEggshellCSonographicCharacteristics

of

BreastMalignantTumors

乳腺惡性腫塊的超聲表現(xiàn)LowerOuterQuadrant(LOQ),Tallerthanwide縱/橫比>1AbundantinbloodflowsignalsMicrocalcifications微鈣化點(diǎn)Subcutaneouslayer皮下組織層FibroadenomaHowtoScanIrregular,spiculated,orangulatedborderThebreastproliferateremarkablyinbothdensityandvolumeBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Retromammarylayer乳腺后層Mammarylayer腺體層TallerthanwideCharacteristicsofMalignantCalcificationsLowerInnerQuadrant(LIQ),細(xì)小鈣化，<1mm。在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Widerthantall縱橫比<1CharacteristicsofMalignantCalcifications

1.Concentratedinonearea,usuallyinthetumor.2.Microcalcifications,<1mm.3.Over5microcalcificationsin1cm2

1.集中于一處，多位于腫塊內(nèi)。

2.細(xì)小鈣化，<1mm。3.每平方厘米微小鈣化數(shù)≥5個(gè)【參考文獻(xiàn)】林薇,廖玲.微小鈣化在乳腺癌X線診斷中的意義.實(shí)用醫(yī)技雜志2006.1

CompanyLogoSonographicCharacteristics

oCancerTallerthanwide縱/橫比>1乳腺超聲診斷CancerTallerthanwide縱/橫比>Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–lTallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>1

惡性腫瘤的生長常常浸潤正常結(jié)構(gòu)而導(dǎo)致前后徑增大，故縱橫比常＞1。TallerthanwideThegrowthofCancerAbundantinbloodflowsignals血流信號豐富CancerAbundantinbloodflowBenigntumorwithrichbloodflowsignals管中窺豹只一斑，葉落難斷已秋天。是峰是嶺橫側(cè)看，超脫物外也非仙！BenigntumorwithrCharacteristicsofBenignTumors

Ovalorround圓形或卵圓形Smooth,sharpborder邊界光滑，清楚Uniformechogenicity回聲均勻Widerthantall縱橫比<1Fibroadenoma纖維腺瘤

CharacteristicsofBenignTumBenignorMalignant？BenignorMalignant？Case1IrregularborderMicrocalcificationsAbundantinbloodflowsignalsMalignantCase1Irregularborder昆明醫(yī)學(xué)院附屬昆華醫(yī)院

超聲科尹欣TallerthanwideBenignorMalignant？AbundantinbloodflowsignalsIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.PregnantFemaleThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>1

惡性腫瘤的生長常常浸潤正常結(jié)構(gòu)而導(dǎo)致前后徑增大，故縱橫比常＞1。LowerOuterQuadrant(LOQ),Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。RetromammarylayerBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Over5microcalcificationsin1cm2ParenchymalPatternsLowerOuterQuadrant(LOQ),Widerthantall縱橫比<1LowerOuterQuadrant(LOQ),AbundantinbloodflowsignalsEggshellCalcificationWiderthantall縱橫比<1UltrasonicDiagnosisofBreastMalignantTumors

乳腺惡性腫瘤的超聲診斷ElderFemale不規(guī)則,毛刺狀,或成角的邊界BreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Irregular,spiculated,orangulatedborder不規(guī)則,毛刺狀,或成角的邊界Over5microcalcificationsin1cm2是峰是嶺橫側(cè)看，超脫物外也非仙！細(xì)小鈣化，<1mm。管中窺豹只一斑，葉落難斷已秋天。每平方厘米微小鈣化數(shù)≥5個(gè)LowerOuterQuadrant(LOQ),HowtoScanSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.LowerOuterQuadrant(LOQ),stageinlife.ParenchymalPatternsAbundantinbloodflowsignalsOvalorround圓形或卵圓形LowerOuterQuadrant(LOQ),超聲對乳腺惡性腫瘤的診斷實(shí)用醫(yī)技雜志2006.IrregularborderLowerOuterQuadrant(LOQ),Subcutaneouslayer皮下組織層composedofwide–longaxis在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Smooth,sharpborder邊界光滑，清楚dependingonherIrregularborderLowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsOvalorround圓形或卵圓形Small,hyperechoicspotswithoutacousticshadowingWiderthantall縱橫比<1SubcutaneouslayerSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Mammarylayer腺體層Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.NOTparallel–tallerthanUpperOuterQuadrant(UOQ),在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。PregnantFemaleLowerOuterQuadrant(LOQ),每平方厘米微小鈣化數(shù)≥5個(gè)ParenchymalPatternsUpperInnerQuadrant(UIQ),Widerthantall縱橫比<1AbundantinbloodflowsignalsAbundantinbloodflowsignalsParallel–widerthantall–longaxisparalleltoskinIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.ThebreasttissuebecomesprogressivelyreplacedwithfatParenchymalPatternsOver5microcalcificationsin1cm2在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。細(xì)小鈣化，<1mm。Abundantinbloodflowsignals細(xì)小鈣化，<1mm。wide–longaxisIrregularborder不同階段乳腺的圖像也不同HowtoScanPregnantFemale每平方厘米微小鈣化數(shù)≥5個(gè)在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。LowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsLowerOuterQuadrant(LOQ),CharacteristicsofMalignantCalcifications在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。CompanyLogoSonographicCharacteristics

of

BreastMalignantTumors

乳腺惡性腫塊的超聲表現(xiàn)Smooth,sharpborder邊界光滑，清楚IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.CharacteristicsofBenignTumorsSubcutaneouslayer謝謝觀看！昆明醫(yī)學(xué)院附屬昆華醫(yī)院

超聲科尹欣Ultrasonic超聲對乳腺惡性腫瘤的診斷超聲對乳腺惡性腫瘤的診斷27UltrasonicDiagnosisofBreastMalignantTumors

乳腺惡性腫瘤的超聲診斷

昆明醫(yī)學(xué)院附屬昆華醫(yī)院

超聲科尹欣

UltrasonicDiagnosisofBreast28Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.BreastcanceristhefirstleaSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.

在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Theselayersinclude:Subcutaneouslayer皮下組織層Mammarylayer腺體層Retromammarylayer乳腺后層AnatomyoftheBreast乳腺的解剖Sonographically,thebreasSubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutaneParenchymalPatterns

Theappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomandependingonherstageinlife.

女性乳腺的圖像在個(gè)體間有很大的差異性，即使是同一人在不同階段乳腺的圖像也不同

ParenchymalPatterns

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纖維組織較多因而腺體回聲細(xì)密YoungFemaleFibrouselementsPregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺顯著增生PregnantFemaleThebreastpElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐漸脂肪化ElderFemaleThebreasttissueHowtoScanThebreastisdividedintofourquadrant

:UpperOuterQuadrant(UOQ),UpperInnerQuadrant(UIQ),LowerOuterQuadrant(LOQ),LowerInnerQuadrant(LIQ),Checkthesefourquadrantinaclockwisedirection

andthenscannipple(乳頭)andoxter（腋下）HowtoScanThebreastisdiSonographicCharacteristics

of

BreastMalignantTumors

乳腺惡性腫塊的超聲表現(xiàn)SonographicCharacteristics

oCancerCrab螃蟹癌癥巨蟹座Cancer癌癥巨蟹座CancerIrregular,spiculated,orangulatedborder

不規(guī)則,毛刺狀,或成角的邊界Crab螃蟹Cancroid蟹足狀的CancerCrab螃蟹Cancroid蟹足狀的CancerBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌

CancerBreastcancerwithIrregBreastCancerMicrocalcifications微鈣化點(diǎn)Small,hyperechoicspotswithoutacousticshadowing細(xì)小，高回聲的光點(diǎn)，不伴后方聲影BreastCancerMicrocalcificatioBenignCalcificationEggshellCalcification

蛋殼樣鈣化BenignCalcificationEggshellCSonographicCharacteristics

of

BreastMalignantTumors

乳腺惡性腫塊的超聲表現(xiàn)LowerOuterQuadrant(LOQ),Tallerthanwide縱/橫比>1AbundantinbloodflowsignalsMicrocalcifications微鈣化點(diǎn)Subcutaneouslayer皮下組織層FibroadenomaHowtoScanIrregular,spiculated,orangulatedborderThebreastproliferateremarkablyinbothdensityandvolumeBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Retromammarylayer乳腺后層Mammarylayer腺體層TallerthanwideCharacteristicsofMalignantCalcificationsLowerInnerQuadrant(LIQ),細(xì)小鈣化，<1mm。在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Widerthantall縱橫比<1CharacteristicsofMalignantCalcifications

1.Concentratedinonearea,usuallyinthetumor.2.Microcalcifications,<1mm.3.Over5microcalcificationsin1cm2

1.集中于一處，多位于腫塊內(nèi)。

2.細(xì)小鈣化，<1mm。3.每平方厘米微小鈣化數(shù)≥5個(gè)【參考文獻(xiàn)】林薇,廖玲.微小鈣化在乳腺癌X線診斷中的意義.實(shí)用醫(yī)技雜志2006.1

CompanyLogoSonographicCharacteristics

oCancerTallerthanwide縱/橫比>1乳腺超聲診斷CancerTallerthanwide縱/橫比>Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–lTallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>1

惡性腫瘤的生長常常浸潤正常結(jié)構(gòu)而導(dǎo)致前后徑增大，故縱橫比常＞1。TallerthanwideThegrowthofCancerAbundantinbloodflowsignals血流信號豐富CancerAbundantinbloodflowBenigntumorwithrichbloodflowsignals管中窺豹只一斑，葉落難斷已秋天。是峰是嶺橫側(cè)看，超脫物外也非仙！BenigntumorwithrCharacteristicsofBenignTumors

Ovalorround圓形或卵圓形Smooth,sharpborder邊界光滑，清楚Uniformechogenicity回聲均勻Widerthantall縱橫比<1Fibroadenoma纖維腺瘤

CharacteristicsofBenignTumBenignorMalignant？BenignorMalignant？Case1IrregularborderMicrocalcificationsAbundantinbloodflowsignalsMalignantCase1Irregularborder昆明醫(yī)學(xué)院附屬昆華醫(yī)院

超聲科尹欣TallerthanwideBenignorMalignant？AbundantinbloodflowsignalsIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.PregnantFemaleThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>1

惡性腫瘤的生長常常浸潤正常結(jié)構(gòu)而導(dǎo)致前后徑增大，故縱橫比常＞1。LowerOuterQuadrant(LOQ),Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。RetromammarylayerBreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Over5microcalcificationsin1cm2ParenchymalPatternsLowerOuterQuadrant(LOQ),Widerthantall縱橫比<1LowerOuterQuadrant(LOQ),AbundantinbloodflowsignalsEggshellCalcificationWiderthantall縱橫比<1UltrasonicDiagnosisofBreastMalignantTumors

乳腺惡性腫瘤的超聲診斷ElderFemale不規(guī)則,毛刺狀,或成角的邊界BreastcancerwithIrregularborder

邊界不規(guī)則的乳腺癌Irregular,spiculated,orangulatedborder不規(guī)則,毛刺狀,或成角的邊界Over5microcalcificationsin1cm2是峰是嶺橫側(cè)看，超脫物外也非仙！細(xì)小鈣化，<1mm。管中窺豹只一斑，葉落難斷已秋天。每平方厘米微小鈣化數(shù)≥5個(gè)LowerOuterQuadrant(LOQ),HowtoScanSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.LowerOuterQuadrant(LOQ),stageinlife.ParenchymalPatternsAbundantinbloodflowsignalsOvalorround圓形或卵圓形LowerOuterQuadrant(LOQ),超聲對乳腺惡性腫瘤的診斷實(shí)用醫(yī)技雜志2006.IrregularborderLowerOuterQuadrant(LOQ),Subcutaneouslayer皮下組織層composedofwide–longaxis在聲像圖中，從皮膚至胸壁可將乳腺組織可分為3層。Smooth,sharpborder邊界光滑，清楚dependingonherIrregularborderLowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsOvalorround圓形或卵圓形Small,hyperechoicspotswithoutacousticshadowingWider