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1、关于超声对乳腺恶性关于超声对乳腺恶性肿瘤的诊断肿瘤的诊断第一页，讲稿共二十八页哦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超声科 尹欣第二页，讲稿共二十八页哦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 li
2、fe time.第三页，讲稿共二十八页哦 Sonographically,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第四页，讲稿共二
3、十八页哦 Subcutaneous layer Retromammary layer composed of Fat and Connective tissue第五页，讲稿共二十八页哦Parenchymal 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
4、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 第六页，讲稿共二十八页哦 Young Female Fibrous 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第七页，讲稿共二十八页哦Pregnant Female The breast proliferate remarkably in both density and volume 妊娠期女性乳腺显著增生第八页，讲稿共二十八页哦Elder FemaleThe breast tiss
5、ue becomes progressively replaced with fat老年期乳腺逐渐脂肪化第九页，讲稿共二十八页哦How to Scan The breast is divided 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)an
6、d oxter（腋下）（腋下）第十页，讲稿共二十八页哦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第十一页，讲稿共二十八页哦CancerCrab螃蟹螃蟹癌症巨蟹座第十二页，讲稿共二十八页哦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 蟹足状的第十三页，讲稿共二十八页哦Breast cancer with Irregular border边界不规则的乳腺癌第十
7、四页，讲稿共二十八页哦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，不伴后方声影第十五页，讲稿共二十八页哦Benign CalcificationEggshell Calcification 蛋壳样钙化蛋壳样钙化第十六页，讲稿共二十八页哦Company LogoCharacteristics of Malignant Calcifications 1.Concentrated in one area,usu
8、ally 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，1第十八页，讲稿共二十八页哦vParallel wider than tall long axis parallel to skinvNOT parallel taller than wide long axis perpendicular to skin 第十九页，讲稿共二十八页哦Taller than widev The growth of malig
9、nant 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。第二十页，讲稿共二十八页哦CancervAbundant in blood flow signals 血流信号丰富血流信号丰富第二十一页，讲稿共二十八页哦 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
10、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！第二十二页，讲稿共二十八页哦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 回声均匀回声均匀v Wider than tall 纵横比纵横比1Fibroadenoma纤维腺瘤纤维腺瘤 第二十三页，讲稿共二十八页哦Benign or Malignant？第二十四页，讲稿共二十八页哦Company LogoCase 1v Irregular
11、borderv Microcalcificationsv Abundant in blood flow signalsMalignant第二十五页，讲稿共二十八页哦Case 2v Ovalv Smooth,sharp borderv Blood flow signals are not rich Benign第二十六页，讲稿共二十八页哦Company LogoPreview Sonographic Characteristics of Thyroid Malignant Tumors 预习：预习：甲状腺恶性肿块的超声表现甲状腺恶性肿块的超声表现第二十七页，讲稿共二十八页哦感谢大家观看第二十八页，讲稿共二十八页哦