乳腺肿瘤的漏诊原因分析.ppt

MRI is widely accepted as a powerful imaging modality for evaluation of the breast in cases of cancer. US-guided percutaneous(经皮的) breast biopsy is generally considered to be quicker, more readily accessible,and less costly than other localization techniques without requiring ionizing radiation(电离辐射) Correct localization * ppt课件 Invasive lobular carcinoma in a 63-year-old man with a 12 mm non-palpable non-mass lesion in the left breast. 病例 * ppt课件 a Bilateral axial and b left sagittal fat-suppressed T1-weighted （脂肪抑制T1加权）breast MR images show clumped ductal（聚集的导管） enhancement (arrows). * ppt课件 c Second-look US of the lower inner left breast shows a corresponding small isoechoic non-mass lesion (arrows). This lesion would have been easily missed on US if there was no breast MRI correlation. US-guided core needle biopsy（细针活检） revealed invasive lobular carcinoma * ppt课件 Breast MRI is performed with patients lying（俯卧位） prone, whereas second-look US is per-formed （仰卧位）with patients in the supine position; this may result in confusion . Therefore, correct correlation between MRI and US is difficult. Correct localization * ppt课件 Correct localization * ppt课件 real-time virtual ultrasonography (RVS)实时虚 拟超声检查 can syn-chronize（同步) US and supine position MR images of the same section in real time . RVS may reduce the differences among operators and increase the physician’s confidence about the MRI-detected lesion. Method avoid * ppt课件 A circumscribed（界限） breast mass is frequently Indicative（认为） of a benign(良性) lesion. However, specific subtypes of high- grade tumors, such as triple-negative and familial breast cancers,are likely to manifest with benign morphological features Misinterpretation * ppt课件 补充知识点：三阴乳腺癌 * ppt课件 女，38y，TNBC，图a钼靶X示乳腺致密肿块影，病 灶大部分边界较为清楚，图b超声示乳腺低回声不均 质肿块影，边界光滑。 * ppt课件 Triple-negative breast cancer (TNBC) in a 63-year-old man with a 38 mm palpable mass in the left breast. a Left MLO view shows a