乳房常規檢查常見的影像 台大醫院影像醫學部 陳曉怡醫事放射師 2013.8.10
Breast Anatomy
Breast tissue Fatty breast Mildly dense ( tissue (scattered fibroglandular Moderate dense ( dense (Heterogeneous Extremely dense
Breast tissue Fatty breast 脂肪型乳房在乳房組織結構中, 幾乎完全是以脂肪組成, 腺體組織佔整體結構不到 25%
Fatty breast
Fatty breast
Breast tissue Mildly dense 略微緻密型在乳房組織結構中的有分散的纖維腺體, 腺體組織約佔整體結構的 25-50%
Mildly dense
Mildly dense
Breast tissue Moderate dense 中等緻密型乳房組織是不均勻地緻密, 有可能會將一些腫塊給掩蓋住而忽略, 腺體組織約佔整體結構的 51-75% 建議最好再以超音波檢查以確認診斷
Moderate dense ( dense (Heterogeneous
Moderate dense ( dense (Heterogeneous
Breast tissue Extremely dense 極端地緻密型乳腺組織在組織結構當中是非常密集, 腺體組織在整體組織中超過 75% 會嚴重降低乳房 X 光攝影檢查的效果, 需要超音波來協助檢查
Extremely dense R CC L CC R MLO L MLO
Extremely dense
Differentiation between benign and malignant 1.Shape 2.Margin 3.Echogenicity 4.Internal echo pattern 5.Retrotumor acoustic phenomenon 6.Compression effect on shape and internal echo pattern 7.Calcification 8.Ratio of anteroposterior to transverse dimension
Calcification Size Distribution Morphology Number
Calcification size 以較短的徑為衡量標準 寬度 Coarse calcification >2mm Microcalcification <1mm 大多個別惡性鈣化點 <0.5mm
Calcification Distribution
Calcification distribution numbers clustered:1cm³ 的範圍內有 5 顆以上的鈣化點 segmental: 以乳頭的乳管開始 每單一主乳管和分支的小管腺會構成一個片段, 分佈在一個片段內的鈣化 regional: 範圍更大的鈣化 scattered: 範圍比 regional 的範圍更大 且分布更隨機
Calcification Morphology Typically benign Typically benign Intermediate Intermediate Great Concerns
F/69 Heterogeneously dense fibroglandular tissue
F/69 Ductal dalated
F/82 Heterogeneously dense fibroglandular tissue A 1.2cm nodular with partially obliterated margin at subareolar UOQ of R`t breast R CC R MLO
F/82 Papilloma Intracystic solid mass Anechoic nodule with smooth and defined borders A grouping of echoes in one sector
R CC R MLO F/46 Heterogeneously dense fibroglandular tissue 2.6cm oval mass at R`t upper central breast
F/46 FA(fibroadenoma)-benign solid nodules Elongated shape,with smooth borders and heterogeneous echostructure Bilobular or trilobular shape Containing a small area of partial calcifaction;with or without posterior sonic attenuation Displaying thick calcifications and total sonic attenuation Heterogeneous,with hemorrhage and/or necrosis
R CC R MLO F/40 Heterogeneously dense fibroglandular tissue 1.7*1.6cm,partially obscured,mild heperdensy mass in R`t upper center breast
F/40 FA Elongated shape,with smooth borders and heterogeneous echostructure Bilobular or trilobular shape Containing a small area of partial calcifaction;with or without posterior sonic attenuation Displaying thick calcifications and total sonic attenuation Heterogeneous,with hemorrhage and/or necrosis
R CC R MLO F/39 Extremely densy 1.8cm oval mass at R`t central outter breast
F/39 Fibrocystic changes,focal adenosis and chronic inflammation
F/39 FCC
F/36 Mastitis 臨床症狀 : 紅. 腫. 熱. 痛. 發燒 Edema and thickening of the skin Alteration in the echogenicity of the tissues Ductal ectasia Increase in the volume of the gland Dilation of lymph vessels parallel to the skin
F/32 Mastitis
L CC L MLO F/42 Heterogeneously dense fibroglandular tissue 6cm lobulated mass,with well circumscribed margin and isodensity at L`t UOQ
F/42 A few ductal epithelial cells, degenerated WBCs and macrophages with cholesterol crystals and cell debris are present in the fluid background.
F/34 Cyst Round or oval shape Anechoic Smooth and well-define borders Posterior acoustic enhancement Lateral acoustic shadow
R R CC CC R R MLO MLO F/27 Extremely densy The margin of the palpable mass at R`t UOQ not well depitced. Regional amorphous and punctate microcalcification in R`t posterior UOQ
R MMLO R MXCCL
F/27 IDC Irregular borders Heterogeneous echo Calcifications Areas of low echogenicity due to necrosis
F/71 Slicon injection for 20-30years IDC(invasive duct carcioma)(for biopsy)
R CC L CC R MLO L MLO F/54 slicon inject Status post free silicone injection with bilatered rim calicifications Present of archiecture distortion of L`t breast with skin thickening as compared at right side
F/54 Foreign body reaction and variable-sized vacuoles (for biopsy)
F/57 Water bag implant A 4.6cm mass in L`t breast lower inner guadrant
F/57 Invasive ductal carcinoma Irregular borders Heterogeneous echo Areas of low echogenicity due to necrosis
F/55 Fat implant
L MLO L MMLO Focal grouped microcalcification in L`t retroareola region on MLO
F/55 mild inflammation with foreignbody reaction
F/26 FC(for biopsy) Tall than wide
F/51 FA(for biopsy) Tall than wide Calcification
Implant image
小針美容 R CC R CC L CC L CC
R MLO L MLO L MLO
R AT L AT
Snowstorm and complex cystic appearance
水袋 R CC L CC
R MLO L MLO
果凍矽膠 R CC L CC
R MLO L MLO
自體脂肪 R CC L CC
R MLO L MLO
玻尿酸
R CC L CC 2011/12/08 F/25 Implant 2013/04/09
R MLO L MLO 2011/12/09 2013/04/09
2011/11/08
2013/03/19
Scar image
Partial mastectomy scar
Mammotone scar
L MLO L CC