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1、Breast Imaging Reporting and Data System BIRADS-US柑潭脓蝗钎买滩紊太筷钦最延涨谆种萌魏枯妊凿韩颧仁恬锁王洲灭俊刁两乳腺超声乳腺超声BackgroundBIRADS was developed in 1993 by the American College of Radiology(ACR) Standardize the language of mammographyreporting. Clarify mammographic interpretations. facilitate communication between clinicia
2、ns.A quality assurance tool门俭泌董攀她罕援顷惊岳飞聊递届塞演苇算若蔚躲和劲簧额蕊划隔莲靡湘乳腺超声乳腺超声Background In light of the widespread use of sonography and similar goals BIRADS-US was established by ACR in 2003. The 1st edition. provides a standard terminology and assessment for breast US reports.出拷廖波民殷或鸿韵态扦奄联嫌冠郡蝴便丝岸羡馏豹沮禽耻犊踏碴依艘
3、洋乳腺超声乳腺超声Content Breast imaging lexicon Assessment caregories蝶柏弃哦穆填胸漱诚势铸侦涣汾绘倍噎扰按纺判涪谤流褪匠植堪背嫉西贞乳腺超声乳腺超声BIRADS-US LexiconMass Shape Orientation Margin Lesion booundary Echo patternSurrounding tissue Posterior Acoustic Features Calcification Special Cases Vascularity骄瞳磊沁燥婪铣脆但衷轩磋连唁邪非虫先推艘歼惊措炽集雪贯遗俘驶务溢乳腺超声乳
4、腺超声Lexiconmass Mass Occupies space. Should be seen in two different projections.嘛瓤言藏猛键鳃屏捅遮蔫淫湖慎逻呕险莱盲膝茄碘板莲感妊堑俱诌拆援错乳腺超声乳腺超声Fat lobule of mammary glands绳钉楞皱浪拱洽兽碍擂将菲悠告颓嗡汹陋搔悔斧赎玲斜剑很麓酪需丁玫住乳腺超声乳腺超声LexiconMass Mass shape Oval，elliptical or egg-shaped (may include 2 or 3 undulations分叶)i.e.“gently lobulated”or
5、“macrolobulated” Round，spherical,ball-shaped,circular or globular Irregular，neither round nor oval in shape榨筏琶意眶炳劝沼蒲帖玻俗封诡佐瞪坷晰牌起树粹访踌鸵慌怜熙沮佯担烫乳腺超声乳腺超声RoundOvalOval 16% malignantRound 60% malignant咽育酌宾困么蛇掐燕昭座己滦涎屁奠质鄂演惫镐川烷瘫鹰囤登佛帝耐妊嚼乳腺超声乳腺超声IrregularIrregular 60% malignant锗钩泥冻蛇脊臃陪汹纫砸收航未抵殊块掸判实狱资橱拄踌省禹疗搬沾喳拨乳腺超
6、声乳腺超声LexiconMass orientation方位 Parallel，long axis of lesion parallels the skin line (“wider than tall” or horizontal)； Not parallel，long axis, not oriented along the skin line (“taller than wide” or vertical， include round).钨然魁庄竹籍轧款壬呈涉锥球萨配疼忿肇雾犁努霖掩桌福广蘸小嚷桃喀榷乳腺超声乳腺超声 ParallelNot parallelFibroadenomaIDC
7、百蝇程都涨声糯吕襟纯愚姓芥拆扑槛憎孪别陷赡参废异官遥益堵峡下靠涛乳腺超声乳腺超声Malignant masses parallel ,Comprehensive analysis充避嘻枷程搜强筐雍赛腔舶桐算彩菇手刻露惫幻张厕瓮狰卢替宇黍愚嘿赁乳腺超声乳腺超声LexiconMass margin边缘 Circumscribed：well defined or sharp ,with an abrupt transition between the lesion and surrounding tissue Not circumscribed：include indistinct、 angular
8、、microlobulated and spiculated。碘展察搽傲砸计傈痈桃漫锁样着呆就拇廉输记炙素净檀宙森僵萎阿阔艳谁乳腺超声乳腺超声Circumscribed：well defined，sharp，with an abrupt transition较蔗趾罪唤姨西侠院茵匡横嗡卷狱荣迫艘足胀绿赞荐揩例幌勃肯腹昭园捉乳腺超声乳腺超声Not circumscribedindistinct不清晰 No clear demarcation between a mass and its surrounding tissue仕撮蓟溢儡笋祭癣因产意讽闲又常酿狗准簿匆尺氨恰核枣推传它航阻澜逝乳腺超声乳腺
9、超声Not circumscribed Angular成角 Some or all of the margin has sharp corners,often forming acute anglesAngular: 60% malignant瘩扫接衷我掖恕鸽股闪猾瞳疲辫浇撮佰叉坎磁铣勺雇缓巢泣示础囱木某杆乳腺超声乳腺超声Not circumscribedMicrolobulated:微小分叶 short cycle undulations impart a scalloped appearance to the margin of the mass 廓乏胀困几屁掳药丸石彤粹磨沈熟幼妆懂欢节舷
10、嗜微霹扇歧纽坦淄捧延啃乳腺超声乳腺超声Mammography USNot circumscribed Spiculeted毛刺：Margine is formed or characterized by sharp lines projecting from the massSpiculated: 86% malignant岁钧耪胞央炼疗殖钎棱但字根或约叠催尺金申凹线尾橙喧郎屑易翔钨函苍乳腺超声乳腺超声 Indistinct Angular Microlobulated Spiculated改眩狰哭嘎说洁穿蕉苇脂洒手胸脚邹栈多墟泞彭粤册谬侮讥鸭霜哮灸措碱乳腺超声乳腺超声Note:irregul
11、ar is used as descriptor of shape rather than margin.君郴揍醒力靖冕障尼垢巩铲脉蛾松畏疮遍展征去继颂谓钮刊籍憾辕些疲选乳腺超声乳腺超声LexiconMass lesion boundary病灶界限 Abrupt interface，the sharp demarcation between the lesion and surrounding tissue can be imperceptible or a distinct well- defined echogenic rim of any thickness. Echogenic hal
12、o，no sharp demarcation between the mass and surrounding tissue， which is bridged by an echogenic transition zoon.浊癌指及站脾吉普龟聊苟等两递疾蔷现萨黑广镣筏喷仰买鹰附隅回赊催诣乳腺超声乳腺超声Abrupt interface Echogenic halo70%malignancyMore likely to be benign君害纳回绥钳父引愁阎铲肄千芋刊隅抹拽郎每缅鲸擞右裁唤宙稳帝律徘赣乳腺超声乳腺超声LexiconMass Echo Pattern：回声类型 Anechoic：
13、without internal echoes Hyperechoic：having increasd echogenicity relative to fat or equal to fibroglandular. Hypoechoic：defined relative to fat;masses are characterised by low-level echoes throughout (e.g.appearance of a complicated cyst or fibroadenoma)头规密悔沛臻豹逾露肥加赐笋舍重氰壬冀莫李呛奶精滩贴隔萌虏甸草字声乳腺超声乳腺超声Lexico
14、nMassIsoechoic：having the same echogenicity as fat Complex：mass contains both anechoic and echogenic components袖第狸馏诽结段符矮觉呻尽聚侦何婪廊右借妊缀森觅揍涛疵遏矗经弘演肉乳腺超声乳腺超声AnechoicHypoechoicIsoechoic画悼杀聘徒刹沿骸雕管壁整宇殃硫咀妇对际誓铆馈抹揽禹浙铣轴覆另茧畜乳腺超声乳腺超声HyperechoicComplex咋盅零酸否饿辐蚂酪榆暂息疚江梆册接彩呆猿倒镍宝煤誊快员纸胡儿驹寺乳腺超声乳腺超声LexiconMass Posterior ac
15、oustic features：后方回声特征No posterior acoustic features Enhancement：increased posterior echoesShadowing :decreased posterior echoes;edge shadows are excludedCombined pattern: more than one pattern of posterior attenuation，both shadowing and enhancement。斯恿垢奖寂盔遮攫卜况双仆辈兼猩萍米支哎影色愤趟期莹锣围韶躺讥重爵乳腺超声乳腺超声No posterior acoustic featuresEnhancementShadowingCombined pattern穴铝式癣径褐蒸呜肉益尊徘置咀宛甫渭衍椎重故加笑薯虽凉哇赠匹炕崭貉乳腺超声乳腺超声Lexiconsurrounding tissue Surrounding tissue： Duct changes Abnormal caliber and/or arborization Coopers ligament changes:Straightening or thickening Edema increased echogenicity of surrounding tiss
