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1、乳腺癌的影像学诊断第1页，本讲稿共28页 Pathological type1.Differentiation of low breast cancer:分化分化低的乳腺癌低的乳腺癌1)hardware carcinoma硬癌2)medullary carcinoma髓样癌3)diffuse carcinoma(also known as inflammatory cancer)弥漫性癌(亦称炎性癌)4)mucinous carcinoma(also known as colloid carcinoma)粘液癌(亦称胶样癌)第2页，本讲稿共28页Pathological type2.Highl
2、y differentiated breast cancer:分化高的乳腺癌 1)adenocarcinoma腺癌2)ductal carcinoma(also known as tube cancer)导管癌(亦称管内癌)3)papillary carcinoma(also known as papillary adenocarcinoma)导管癌(亦称管内癌)4)eczema-like cancer(also known as Pagets nipple disease)湿疹样癌(亦称Paget氏乳头病)第3页，本讲稿共28页Clinical manifestationsBreast lu
3、mps 乳房肿块Nipple discharge 乳头溢液Changes in the breast skin and contour乳房皮肤及轮廓改变第4页，本讲稿共28页Inspection methodsUltrasoundMammography 钼靶X线 MRINear infrared scanning 近红外线扫描 Positron emission tomography(PET)Enhanced CT第5页，本讲稿共28页Ultrasound Solid hypoecho低回声低回声Without capsule无包膜包膜Border clearance边界清边界清Heterog
4、eneous不均匀不均匀internal echoStrong echo can be seen clustered calcifications钙化钙化第6页，本讲稿共28页mammographySee the upper outer quadrant mass in shallow leaf浅分叶肿块影Less clear boundarySee clusters of calcification 其内见成簇钙化第7页，本讲稿共28页MRI should no longer be regarded as an adjunct to mammography but as a distinct
5、 breast cancer in its earliest stage.“MRI 不再是钼靶X线的辅助方法，而是作为乳腺癌早期诊断的独立检查方法。”第8页，本讲稿共28页 MRI Features（breast cancer）T1WI low signalT2WI Increased signal 第9页，本讲稿共28页MRI FeaturesIrregular不规则massLobulated分叶状edges Blur模糊,rough毛糙Crab-like growth呈蟹足样生长Ill-defined,第10页，本讲稿共28页MRI FeaturesLiquefaction necrosi
6、s液化坏死seen in the larger lesions第11页，本讲稿共28页MRI FeaturesQuick significantly明显enhancedRapid clearance廓清Around the beginning of the spread of the disease centers 向心性强化Liquefaction necrosis and bleeding液化坏死及出血has always been part of no enhancement第12页，本讲稿共28页Time-intensity curves（TIC）TypeClearance type
7、type持续型平台型廓清型PersistentPlatform Type第13页，本讲稿共28页Time-intensity curves（TIC）Most of the benign lesions showed persistent持续型to enhanceMost malignant lesions showed clearance-type廓清型enhancedPlatform-type平台型can be benign lesions,but also for malignant lesions.第14页，本讲稿共28页Diagnosis of breast cancer BI-RAD
8、S classification 分级Level 0:assessed评估is not complete,to further assess the need for other imagingLevel 1:no abnormal findings无异常发现 Level 2:Benign found良性发现-routine follow-upLevel 3:Possible positive findings可能良性发现-short-term follow-upLevel 4:Low-Moderate suspicious malignant低-中度可疑恶性-consider biopsyL
9、evel 5:highly suspected malignancy高度怀疑恶性-Level 6:malignant lesions biopsy confirm 已活检证实的恶性病变第15页，本讲稿共28页Differential鉴别Diagnosis 1Breast fibroadenoma：纤维腺瘤 Often occurs in young female，Mass often smooth光滑edge，Similar density and glands腺体，Coarse calcification within the visible，Strengthen even,slow,was
10、 eccentric.第16页，本讲稿共28页Differential Diagnosis 2Hyperplasia增生：Local gland increased,edges blur模糊Enhanced with a slow,progressive渐进性enhancement，In the late enhancement,lesion degree of enhancement increasing trend 第17页，本讲稿共28页Differential Diagnosis 3Breast cyst囊肿：appear as significant long T1 and long
11、 T2 singal intensity第18页，本讲稿共28页Photo Review 纤维腺瘤1a）show low T1WI signal mass at the left breast1b）show high T2WI signal mass,edge clear第19页，本讲稿共28页Photo Review 纤维腺瘤 2a）T2WI mass signal was slightly lower2b）Enhanced scan mass lesion in the breast deep,sharp edges and strengthen a more even第20页，本讲稿共2
12、8页Photo Review纤维腺瘤 3a）Enhanced mass in the right breast showed a more homogeneous均匀enhancement3b）Curve for the lesion type type curve for the normal glands第21页，本讲稿共28页Photo Review浸润性导管癌4a）Mass within the left breast was significantly明显enhanced 4b）Dynamic enhancement curves of the type (clearance typ
13、e)第22页，本讲稿共28页Photo Review浸润性导管癌5a）X-ray image Right breast near the chest wall see the mass5b）Significantly enhanced lesions,irregular不规则margin第23页，本讲稿共28页Photo Review浸润性导管癌6a）X-ray image Large calcified lesions in the breast 6b）The outer upper quadrant lesions within the chip heterogeneous不均匀enhan
14、cement第24页，本讲稿共28页Photo Review乳腺囊肿第25页，本讲稿共28页Photo Review乳腺增生第26页，本讲稿共28页Summary Middle-aged women with multiple多发 Was infiltrating浸润the surrounding tissue invasion aptitudeMass of edge the rough rf毛糙 Enhance the rapid clearance was quickly apparent Strengthen the MindMass examination hard,poor activity活动度差第27页，本讲稿共28页Thank you ！第28页，本讲稿共28页