乳腺影像学

Imaging Modalities
1.5T MRI GE signa gemsow
0.5T MRI GE signa Sys#MRS
Shanghai 2nd Medical University
Rui Jin Hospital
X-ray Examination Mammograpy
X-ray radiography (molybdenum X rays, rhodium X rays):MLO,CC,etc.
Imaging Findings of Fibroadenoma
X-ray CT MRI
X-ray Findings
Round, lobular or oval mass or nodule ,smooth nodule in high density with thin ring/ halo in low density
tissue Calcification Intermediate enhancement, linear type or
plateau,relatively long duration of enhancement
Breast Cancer overview
most frequent malignancy in women
Computed tomography
✓plain scan, ✓enhanced scan (iodine)
MRI
Magnetic Resonance Imaging
✓high resolution for soft tissue ✓different tissue, different signal ✓enhanced scan
The others
Infrared thermal imaging Computer diaphanography imaging,etc.
Imaging-Guided Percutaneous Biopsy
supply specimens for pathologic examination
Breast Cancer overview
Age: 40-60yrs, in China 1/5 are <35yrs Gender: female (male) Clinical
✓mass: unmovable mass, ✓skin,orange-peel-like,retraction ✓aching ✓retraction/discharge of nipple ✓enlargement of blood vessels ✓stiffness of breast ✓lymph nodes
Number: solitary or multiple
Calcification
Size: large or micro Shape: ring-like, nodular or salt-like, branching Distribution: scattered or clustered with or
And the imaging modalities implemented in clinical practice for breast care must be served as the tools for detection and characterization of breast lesions. As we expect, they are very important for diagnosis and treatment.
Enlargement of Lymph Nodes
Axillary or intramammary lymph nodes
Administration of Contrast Agents for Breast Lesions
Implication of the lesion’s hemodynamics ✓washout type--malignant ✓linear--benign ✓plateau--malignant/benign
site: upper-outer quadrant breast, upper-inner quadrant
breast, lower outer quadrant breast, lower-inner quadrant breast, nipple, central portion breast, axillary tail breast.
Galactography --demonstrates the ducts and ductule or their abnormalities.
galactography
USG
Ultrasonography (ultrasound)
✓B-mode US ✓Doppler US
CT
without mass benign / malignant
Thickening and Retraction of Regional Skin
Frequently found in malignant tumors
Sometimes due to postsurgical scars.
Fine needle aspiration biopsy (FNAB) Needle core biopsy (NCB)
Interventional Therapy
Laser Radiofrequency Embolization and so on
Accessory Breast Tissue
Retraction of nipple Thickening of skin Abnormal blood vessel Large patchy region in high density
CT Findings of Breast Cancer(1)
Mass: irregular/ill-shaped, coarse margin, spiculation, CT value: 25-56HU, higher than the normal breast, necrosis at the center of the large mass(mostly >= 5cm)
✓1% in adult women in China ✓34.4/100 thousand in 1989 ✓39.7/100 thousand in 1993 ✓46/100 thousand in 1997 ✓52.98/100 thousand in women of Shanghai in 2001 ✓over 100/100 thousand in women in Europe and USA
Skin, nipple Infiltration into the pectoralis major muscle
CT Findings of Breast Cancer(2)
Occupying of retromammary space Enlargement of lymph nodes, axillary/retromammary Administration of contrast agents
The most common site is axilla
Basic Imaging Signs of Breast Lesion
Mass/Lump Calcification Thickening and retraction of regional skin Retraction of nipple Enlargement or abnormality of blood vessels Lymph nodes Enhanced manifestations
Mass/Lump
shape: round, oval, regular/irregular margin: clear or ambiguous, spiculation or smooth density or signal intensity: high/low/intermediate
with or without calcification
Common Diseases in Breast
Fibroadenoma Cyst Lobular hyperplasia Cancer
Fibroadenoma overview
Frequency: most common tumor of breast (benign) Age: below 30 yrs Distribution: unilateral or bilateral Source tissue: connective tissue and glandular tissue Site: upper-outer quadrant Size: < 5cm Surface: smooth, movable
Retraction of Nipple
Congenital-dysplasia Acquired-malignant tumor
Biblioteka Baidu
Enlargement or Abnormality of Blood Vessel
Mostly in malignant tumor due to increase of blood supply
Irregular/regular mass Ambiguous border Spiculations Heterogeneous density, mostly higher than
the Surrounding tissue Site: over 50% at upper-outer quadrant
Breast Cancer overview
Pathology
Invasive ductal carcinoma Intraductal carcinoma Lobular carcinoma(invasive/in situ) Special types
65-80% 15% 5% 10%
X-ray Findings of Breast Cancer(1)
X-ray findings of breast cancer(2)
Calcification: clustered salt-like microcalcification in 1/3 cases inside/outside the mass, sometimes only the microcalcifications observed
Breast Imaging
Basic Course For Medical College Student
WANG Deng-bin MD,Ph.D
Dept. of Radiology,RuiJin Hospital
Introduction
“Breast cancer is one of the best studied human tumors, but it remains poorly understood” “ As in all medical endeavors, the practitioner should, whenever possible, use the results of scientific studies to guide clinical decision”
Compression of surrounding tissue Large calcification:always dominated at the
center of tumor
CT Findings
Round smooth mass/nodule Value of CT similar to normal glandular