超声对乳腺恶性肿瘤的诊断课件

超声对乳腺恶性肿瘤的诊断超声对乳腺恶性肿瘤的诊断1（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2UltrasonicDiagnosisofBreastMalignantTumors

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

UltrasonicDiagnosisofBreast3Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.Breastcanceristhefirstlea4Sonographically,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,thebreas5SubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutane6ParenchymalPatterns

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

ParenchymalPatterns7

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纤维组织较多因而腺体回声细密YoungFemaleFibrouselements8昆明医学院附属昆华医院

超声科尹欣Uniformechogenicity回声均匀Microcalcifications微钙化点Checkthesefourquadrantinaclockwisedirectionandthenscannipple(乳头)andoxter（腋下）EggshellCalcificationHowtoScanSubcutaneouslayerThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。BreastcancerwithIrregularborder

边界不规则的乳腺癌不规则,毛刺状,或成角的边界Small,hyperechoicspotswithoutacousticshadowingLowerInnerQuadrant(LIQ),YoungFemaleFibrouselementspredominateandreflectsadenseechogenicoftissuestageinlife.BenignCalcificationTallerthanwide纵/横比>1女性乳腺的图像在个体间有很PregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺显著增生昆明医学院附属昆华医院

超声科尹欣PregnantFe9ElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐渐脂肪化ElderFemaleThebreasttissue10HowtoScanThebreastisdividedintofourquadrant

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

andthenscannipple(乳头)andoxter（腋下）HowtoScanThebreastisdi11SonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现SonographicCharacteristics

o12CancerCrab螃蟹癌症巨蟹座Cancer癌症巨蟹座13CancerIrregular,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14CancerBreastcancerwithIrregularborder

边界不规则的乳腺癌

CancerBreastcancerwithIrreg15女性乳腺的图像在个体间有很Smooth,sharpborder边界光滑，清楚不规则,毛刺状,或成角的边界TheappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomanTallerthanwideWiderthantall纵横比<1FatandConnectivetissueBenignCalcificationSubcutaneouslayerRetromammarylayerHowtoScanCompanyLogoSubcutaneouslayer集中于一处，多位于肿块内。BenignCalcification在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。LowerInnerQuadrant(LIQ),不规则,毛刺状,或成角的边界Thegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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BreastCancerMicrocalcifications微钙化点Small,hyperechoicspotswithoutacousticshadowing细小，高回声的光点，不伴后方声影女性乳腺的图像在个体间有很BreastCancerMicr16BenignCalcificationEggshellCalcification

蛋壳样钙化BenignCalcificationEggshellC17CompanyLogoCharacteristicsofMalignantCalcifications

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

CompanyLogoCharacteristicsof18CancerTallerthanwide纵/横比>1乳腺超声诊断CancerTallerthanwide纵/横比>19Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–l20TallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。TallerthanwideThegrowthof21CancerAbundantinbloodflowsignals血流信号丰富CancerAbundantinbloodflow22Benigntumorwithrichbloodflowsignals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！Benigntumorwithr23SubcutaneouslayerRetromammarylayerBenignCalcification乳腺的解剖BenignCalcification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MammarylayerIrregular,spiculated,orangulatedborderTallerthanwidestageinlife.ElderFemaleUpperInnerQuadrant(UIQ),Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.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UpperOuterQuadrant(UOQ),Irregular,spiculated,orangulatedborderMammarylayerIrregular,spiculated,orangulatedborderSmall,hyperechoicspotswithoutacousticshadowing不规则,毛刺状,或成角的边界Sonographically,thebreastisdividedintothreelayersbetweentheskinandthechestwall.Thegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。RetromammarylayerFibrouselementspredominateandreflectsadenseechogenicoftissue不同阶段乳腺的图像也不同BreastCancerConcentratedinonearea,usuallyinthetumor.Thebreasttissuebecomesprogressivelyreplacedwithfat不规则,毛刺状,或成角的边界BenignCalcificationTallerthanwide纵/横比>1CompanyLogoUniformechogenicity回声均匀乳腺的解剖Tallerthanwide纵/横比>1ElderFemaleTallerthanwideCharacteristicsofBenignTumors

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

SubcutaneouslayerRetroma24超声对乳腺恶性肿瘤的诊断超声对乳腺恶性肿瘤的诊断25（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26UltrasonicDiagnosisofBreastMalignantTumors

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

UltrasonicDiagnosisofBreast27Breastcanceristhefirstleadingcauseofdeathforwomenallovertheworld.IntheUnitedStatesmorethan8%womenwillsufferthisdiseaseduringtheirlifetime.Breastcanceristhefirstlea28Sonographically,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,thebreas29SubcutaneouslayerMammarylayerRetromammarylayer

SubcutaneouslayerRetromammarylayer

composedof

FatandConnectivetissueSubcutaneouslayerSubcutane30ParenchymalPatterns

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

ParenchymalPatterns31

YoungFemale

Fibrouselementspredominateandreflectsadenseechogenicoftissue青春期女性乳腺纤维组织较多因而腺体回声细密YoungFemaleFibrouselements32昆明医学院附属昆华医院

超声科尹欣Uniformechogenicity回声均匀Microcalcifications微钙化点Checkthesefourquadrantinaclockwisedirectionandthenscannipple(乳头)andoxter（腋下）EggshellCalcificationHowtoScanSubcutaneouslayerThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。BreastcancerwithIrregularborder

边界不规则的乳腺癌不规则,毛刺状,或成角的边界Small,hyperechoicspotswithoutacousticshadowingLowerInnerQuadrant(LIQ),YoungFemaleFibrouselementspredominateandreflectsadenseechogenicoftissuestageinlife.BenignCalcificationTallerthanwide纵/横比>1女性乳腺的图像在个体间有很PregnantFemale

Thebreastproliferateremarkablyinbothdensityandvolume

妊娠期女性乳腺显著增生昆明医学院附属昆华医院

超声科尹欣PregnantFe33ElderFemaleThebreasttissuebecomesprogressivelyreplacedwithfat老年期乳腺逐渐脂肪化ElderFemaleThebreasttissue34HowtoScanThebreastisdividedintofourquadrant

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

andthenscannipple(乳头)andoxter（腋下）HowtoScanThebreastisdi35SonographicCharacteristics

of

BreastMalignantTumors

乳腺恶性肿块的超声表现SonographicCharacteristics

o36CancerCrab螃蟹癌症巨蟹座Cancer癌症巨蟹座37CancerIrregular,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38CancerBreastcancerwithIrregularborder

边界不规则的乳腺癌

CancerBreastcancerwithIrreg39女性乳腺的图像在个体间有很Smooth,sharpborder边界光滑，清楚不规则,毛刺状,或成角的边界TheappearanceoftheglandularelementsofthebreastvaryremarkablyfromwomantowomanandvarywithinthesamewomanTallerthanwideWiderthantall纵横比<1FatandConnectivetissueBenignCalcificationSubcutaneouslayerRetromammarylayerHowtoScanCompanyLogoSubcutaneouslayer集中于一处，多位于肿块内。BenignCalcification在声像图中，从皮肤至胸壁可将乳腺组织可分为3层。LowerInnerQuadrant(LIQ),不规则,毛刺状,或成角的边界Thegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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BreastCancerMicrocalcifications微钙化点Small,hyperechoicspotswithoutacousticshadowing细小，高回声的光点，不伴后方声影女性乳腺的图像在个体间有很BreastCancerMicr40BenignCalcificationEggshellCalcification

蛋壳样钙化BenignCalcificationEggshellC41CompanyLogoCharacteristicsofMalignantCalcifications

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

CompanyLogoCharacteristicsof42CancerTallerthanwide纵/横比>1乳腺超声诊断CancerTallerthanwide纵/横比>43Parallel–widerthantall–longaxisparalleltoskinNOTparallel–tallerthanwide–longaxisperpendiculartoskin

Parallel–widerthantall–l44TallerthanwideThegrowthofmalignanttumorsareofteninfiltratesurroundingstructuresandresultingtheaspectratiois>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。TallerthanwideThegrowthof45CancerAbundantinbloodflowsignals血流信号丰富CancerAbundantinbloodflow46Benigntumorwithrichbloodflowsignals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！Benigntumorwithr47SubcutaneouslayerRetromammarylayerBenignCalcification乳腺的解剖BenignCalcification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MammarylayerIrregular,spiculated,orangulatedborderTa