乳腺影像学诊断(英文版).ppt

* Let’s have a summary. When a woman came to the hospital for mammary screening, she should have a physical exam and mammography. If both two examinations found the malignant lesion, she must go to operation. If the physician felt something but the mammogram showed nothing, remember you mustn’t let her go, an ultrasound was necessary, then according to the result of ultrasound, the patient could choose operation, 6 months follow up and biopsy. If the physician found nothing, but the X ray showed mass or calcifications possibly malignant, then the patient needed biopsy. If both two exams found normal, that’s OK, 1year follow up was enough. Imaging examinations of breasts Question How to choose a proper examination for screening and diagnosis What examinations we could use Breast cancer Higher incident rate of breast cancer for recent years Risk factors: procreation, family history, environment, hormone …… Clinic findings：mass，skin changes The survival rate based on the stage of breast cancer Screening：ductal carcinoma in situ Anatomy 15－18 lobes Lobules: Terminal Ductal Lobular Units (TDLUs) Anatomy TDLU：1－2mm Drained by a terminal duct attached to the main duct system Most breast diseases arise in TDLU Imaging methods Mammography Ultrasound MRI Projection： CC MLO Mammography Mammographic characters Calcification Mass Calcification PO43- Calcium phosphat Ca++ Calcification The main value : detection necrotic tissues Form: Casting type, powderish, granular type Differentiation between malignant and benign: distribution, form, density Calcification Calcification Calcification Calcification Mass Proliferation and invasion Stellate lesion with spicules and ill-defined borders Differentiation between malignant and benign is difficult Mass Mass Mass Mass Characteristics of mammography Sensitive to the malignant calcification even microcalcifications Differentiation between benign and malignant mass is difficult Characteristics of Ult