医学乳腺影像学诊疗讲课比赛.pptVIP

乳腺影像学诊疗讲课比赛

QuestionHowtochooseaproperexaminationforscreeninganddiagnosis??Whatexaminationswecoulduse

BreastcancerHigherincidentrateofbreastcancerforrecentyearsRiskfactors:procreation,familyhistory,environment,hormone……Clinicfindings：mass，skinchangesThesurvivalratebasedonthestageofbreastcancerScreening：ductalcarcinomainsitu

Anatomy15－18lobesLobules:TerminalDuctalLobularUnits(TDLUs)

AnatomyTDLU：1－2mmDrainedbyaterminalductattachedtothemainductsystemMostbreastdiseasesariseinTDLU

ImagingmethodsMammographyUltrasoundMRI

Projection：CCMLOMammography

MammographiccharactersCalcificationMass

CalcificationPO43-CalciumphosphatCa++

CalcificationThemainvalue:detectionnecrotictissuesForm:Castingtype,powderish,granulartypeDifferentiationbetweenmalignantandbenign:distribution,form,density

Calcification

Calcification

Calcification

Calcification

MassProliferationandinvasionStellatelesionwithspiculesandill-definedbordersDifferentiationbetweenmalignantandbenignisdifficult

Mass

Mass

Mass

Mass

CharacteristicsofmammographySensitivetothemalignantcalcificationevenmicrocalcificationsDifferentiationbetweenbenignandmalignantmassisdifficult

CharacteristicsofUltrasoundExamAllowssignificantfreedominobtainingimagesfromalmostanyorientationexcellentatimagingcystsandsolidmassyoungwomenathighriskofthediseaseGuidebiopsy

LimitedofultrasoundThoughultrasoundhasexcellentcontrastresolution,itlacksthedetail(spatialresolution)Operatorandequipmentfactorsunabletoimagemicrocalcifications

BenefitsofMRIExamAllowsbreastimagestobetakeninanyplaneandfromanyorientationhighlysensitivetosmallabnormalities,couldshowmulti-focaltumorDeterminingtheextentofbreastcancer,canhelpindicatetreatmentAnexcellentatimagingtheaugmentedbreast

LimitedofMRIExamTooexpensiveCouldn’tfindthemicrocalcification

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