超声对乳腺恶性肿瘤的诊断完美课课件

超声对乳腺恶性肿瘤的诊断超声对乳腺恶性肿瘤的诊断1UltrasonicDiagnosisofBreastMalignantTumors

乳腺恶性肿瘤的超声诊断

昆明医学院附属昆华医院

超声科尹欣

UltrasonicDiagnosisofBreast2Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.BreastcanceristhefirstleaSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.

在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Theselayersinclude:Subcutaneouslayer皮下组织层Mammarylayer腺体层Retromammarylayer乳腺后层AnatomyoftheBreast乳腺的解剖Sonographically,thebreasSubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutaneParenchymalPatterns

Theappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomandependingonherstageinlife.

女性乳腺的图像在个体间有很大的差异性，即使是同一人在不同阶段乳腺的图像也不同

ParenchymalPatterns

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纤维组织较多因而腺体回声细密YoungFemaleFibrouselementsPregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺显著增生PregnantFemaleThebreastpElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐渐脂肪化ElderFemaleThebreasttissueHowtoScanThebreastisdividedintofourquadrant

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

andthenscannipple(乳头)andoxter（腋下）HowtoScanThebreastisdiSonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现SonographicCharacteristics

oCancerCrab螃蟹癌症巨蟹座Cancer癌症巨蟹座CancerIrregular,spiculated,orangulatedborder

不规则,毛刺状,或成角的边界Crab螃蟹Cancroid蟹足状的CancerCrab螃蟹Cancroid蟹足状的CancerBreastcancerwithIrregularborder

边界不规则的乳腺癌

CancerBreastcancerwithIrregBreastCancerMicrocalcifications微钙化点Small,hyperechoicspotswithoutacousticshadowing细小，高回声的光点，不伴后方声影BreastCancerMicrocalcificatioBenignCalcificationEggshellCalcification

蛋壳样钙化BenignCalcificationEggshellCSonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现LowerOuterQuadrant(LOQ),Tallerthanwide纵/横比>1AbundantinbloodflowsignalsMicrocalcifications微钙化点Subcutaneouslayer皮下组织层FibroadenomaHowtoScanIrregular,spiculated,orangulatedborderThebreastproliferateremarkablyinbothdensityandvolumeBreastcancerwithIrregularborder

边界不规则的乳腺癌Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Retromammarylayer乳腺后层Mammarylayer腺体层TallerthanwideCharacteristicsofMalignantCalcificationsLowerInnerQuadrant(LIQ),细小钙化，<1mm。在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Widerthantall纵横比<1CharacteristicsofMalignantCalcifications

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

1.集中于一处，多位于肿块内。

2.细小钙化，<1mm。3.每平方厘米微小钙化数≥5个【参考文献】林薇,廖玲.微小钙化在乳腺癌X线诊断中的意义.实用医技杂志2006.1

CompanyLogoSonographicCharacteristics

oCancerTallerthanwide纵/横比>1乳腺超声诊断CancerTallerthanwide纵/横比>Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–lTallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。TallerthanwideThegrowthofCancerAbundantinbloodflowsignals血流信号丰富CancerAbundantinbloodflowBenigntumorwithrichbloodflowsignals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！BenigntumorwithrCharacteristicsofBenignTumors

Ovalorround圆形或卵圆形Smooth,sharpborder边界光滑，清楚Uniformechogenicity回声均匀Widerthantall纵横比<1Fibroadenoma纤维腺瘤

CharacteristicsofBenignTumBenignorMalignant？BenignorMalignant？Case1IrregularborderMicrocalcificationsAbundantinbloodflowsignalsMalignantCase1Irregularborder昆明医学院附属昆华医院

超声科尹欣TallerthanwideBenignorMalignant？AbundantinbloodflowsignalsIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.PregnantFemaleThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。LowerOuterQuadrant(LOQ),Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。RetromammarylayerBreastcancerwithIrregularborder

边界不规则的乳腺癌Over5microcalcificationsin1cm²ParenchymalPatternsLowerOuterQuadrant(LOQ),Widerthantall纵横比<1LowerOuterQuadrant(LOQ),AbundantinbloodflowsignalsEggshellCalcificationWiderthantall纵横比<1UltrasonicDiagnosisofBreastMalignantTumors

乳腺恶性肿瘤的超声诊断ElderFemale不规则,毛刺状,或成角的边界BreastcancerwithIrregularborder

边界不规则的乳腺癌Irregular,spiculated,orangulatedborder不规则,毛刺状,或成角的边界Over5microcalcificationsin1cm²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LowerOuterQuadrant(LOQ),HowtoScanSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.LowerOuterQuadrant(LOQ),stageinlife.ParenchymalPatternsAbundantinbloodflowsignalsOvalorround圆形或卵圆形LowerOuterQuadrant(LOQ),超声对乳腺恶性肿瘤的诊断实用医技杂志2006.IrregularborderLowerOuterQuadrant(LOQ),Subcutaneouslayer皮下组织层composedofwide–longaxis在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Smooth,sharpborder边界光滑，清楚dependingonherIrregularborderLowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsOvalorround圆形或卵圆形Small,hyperechoicspotswithoutacousticshadowingWiderthantall纵横比<1SubcutaneouslayerSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Mammarylayer腺体层Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.NOTparallel–tallerthanUpperOuterQuadrant(UOQ),在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。PregnantFemaleLowerOuterQuadrant(LOQ),每平方厘米微小钙化数≥5个ParenchymalPatternsUpperInnerQuadrant(UIQ),Widerthantall纵横比<1AbundantinbloodflowsignalsAbundantinbloodflowsignalsParallel–widerthantall–longaxisparalleltoskinIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.ThebreasttissuebecomesprogressivelyreplacedwithfatParenchymalPatternsOver5microcalcificationsin1cm²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。Abundantinbloodflowsignals细小钙化，<1mm。wide–longaxisIrregularborder不同阶段乳腺的图像也不同HowtoScanPregnantFemale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。LowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsLowerOuterQuadrant(LOQ),CharacteristicsofMalignantCalcifications在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。CompanyLogoSonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现Smooth,sharpborder边界光滑，清楚IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.CharacteristicsofBenignTumorsSubcutaneouslayer谢谢观看！昆明医学院附属昆华医院

超声科尹欣Ultrasonic超声对乳腺恶性肿瘤的诊断超声对乳腺恶性肿瘤的诊断27UltrasonicDiagnosisofBreastMalignantTumors

乳腺恶性肿瘤的超声诊断

昆明医学院附属昆华医院

超声科尹欣

UltrasonicDiagnosisofBreast28Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.BreastcanceristhefirstleaSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.

在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Theselayersinclude:Subcutaneouslayer皮下组织层Mammarylayer腺体层Retromammarylayer乳腺后层AnatomyoftheBreast乳腺的解剖Sonographically,thebreasSubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutaneParenchymalPatterns

Theappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomandependingonherstageinlife.

女性乳腺的图像在个体间有很大的差异性，即使是同一人在不同阶段乳腺的图像也不同

ParenchymalPatterns

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纤维组织较多因而腺体回声细密YoungFemaleFibrouselementsPregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺显著增生PregnantFemaleThebreastpElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐渐脂肪化ElderFemaleThebreasttissueHowtoScanThebreastisdividedintofourquadrant

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

andthenscannipple(乳头)andoxter（腋下）HowtoScanThebreastisdiSonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现SonographicCharacteristics

oCancerCrab螃蟹癌症巨蟹座Cancer癌症巨蟹座CancerIrregular,spiculated,orangulatedborder

不规则,毛刺状,或成角的边界Crab螃蟹Cancroid蟹足状的CancerCrab螃蟹Cancroid蟹足状的CancerBreastcancerwithIrregularborder

边界不规则的乳腺癌

CancerBreastcancerwithIrregBreastCancerMicrocalcifications微钙化点Small,hyperechoicspotswithoutacousticshadowing细小，高回声的光点，不伴后方声影BreastCancerMicrocalcificatioBenignCalcificationEggshellCalcification

蛋壳样钙化BenignCalcificationEggshellCSonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现LowerOuterQuadrant(LOQ),Tallerthanwide纵/横比>1AbundantinbloodflowsignalsMicrocalcifications微钙化点Subcutaneouslayer皮下组织层FibroadenomaHowtoScanIrregular,spiculated,orangulatedborderThebreastproliferateremarkablyinbothdensityandvolumeBreastcancerwithIrregularborder

边界不规则的乳腺癌Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Retromammarylayer乳腺后层Mammarylayer腺体层TallerthanwideCharacteristicsofMalignantCalcificationsLowerInnerQuadrant(LIQ),细小钙化，<1mm。在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Widerthantall纵横比<1CharacteristicsofMalignantCalcifications

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

1.集中于一处，多位于肿块内。

2.细小钙化，<1mm。3.每平方厘米微小钙化数≥5个【参考文献】林薇,廖玲.微小钙化在乳腺癌X线诊断中的意义.实用医技杂志2006.1

CompanyLogoSonographicCharacteristics

oCancerTallerthanwide纵/横比>1乳腺超声诊断CancerTallerthanwide纵/横比>Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–lTallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。TallerthanwideThegrowthofCancerAbundantinbloodflowsignals血流信号丰富CancerAbundantinbloodflowBenigntumorwithrichbloodflowsignals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！BenigntumorwithrCharacteristicsofBenignTumors

Ovalorround圆形或卵圆形Smooth,sharpborder边界光滑，清楚Uniformechogenicity回声均匀Widerthantall纵横比<1Fibroadenoma纤维腺瘤

CharacteristicsofBenignTumBenignorMalignant？BenignorMalignant？Case1IrregularborderMicrocalcificationsAbundantinbloodflowsignalsMalignantCase1Irregularborder昆明医学院附属昆华医院

超声科尹欣TallerthanwideBenignorMalignant？AbundantinbloodflowsignalsIntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.PregnantFemaleThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。LowerOuterQuadrant(LOQ),Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。RetromammarylayerBreastcancerwithIrregularborder

边界不规则的乳腺癌Over5microcalcificationsin1cm²ParenchymalPatternsLowerOuterQuadrant(LOQ),Widerthantall纵横比<1LowerOuterQuadrant(LOQ),AbundantinbloodflowsignalsEggshellCalcificationWiderthantall纵横比<1UltrasonicDiagnosisofBreastMalignantTumors

乳腺恶性肿瘤的超声诊断ElderFemale不规则,毛刺状,或成角的边界BreastcancerwithIrregularborder

边界不规则的乳腺癌Irregular,spiculated,orangulatedborder不规则,毛刺状,或成角的边界Over5microcalcificationsin1cm²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LowerOuterQuadrant(LOQ),HowtoScanSonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.LowerOuterQuadrant(LOQ),stageinlife.ParenchymalPatternsAbundantinbloodflowsignalsOvalorround圆形或卵圆形LowerOuterQuadrant(LOQ),超声对乳腺恶性肿瘤的诊断实用医技杂志2006.IrregularborderLowerOuterQuadrant(LOQ),Subcutaneouslayer皮下组织层composedofwide–longaxis在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。Smooth,sharpborder边界光滑，清楚dependingonherIrregularborderLowerOuterQuadrant(LOQ),CharacteristicsofBenignTumorsOvalorround圆形或卵圆形Small,hyperechoicspotswithoutacousticshadowingWider