Atlas of Full Breast Ultrasonography

392 Pages·2016·67.03 MB·English

by  Aristida Colan-Georges (auth.)

Aristida Colan-Georges
Atlas of Full Breast
Ultrasonography
123
Atlas of Full Breast Ultrasonography

Aristida Colan-Georges
Atlas of Full Breast
Ultrasonography
Aristida Colan-Georges
Department of Radiology and Imaging Diagnosis
County Emergency Clinical Hospital
Craiova , Dolj
Romania
ISBN 978-3-319-31417-4 ISBN 978-3-319-31418-1 (eBook)
DOI 10.1007/978-3-319-31418-1
Library of Congress Control Number: 2016945363
© Springer International Publishing Switzerland 2016
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“The missing link in classical breast imaging: the systematic correspondence
with anatomy,” as says Teboul, who renewed the breast US since 1995.
Moreover, “It is not possible to assess that a breast has been adequately
investigated if its ductal-lobular structures have not been observed.”
Michel Teboul
“No classic method in routine allows the differentiation of a ductal lesion and
a lobular one. Only DUCTAL echography is a technique which offers us, with
its remarkable accuracy, the possibility of analysis and comprehension of the
ANATOMY and thus of a better approach of the pathological alterations at an
early stage. Already used successfully by some European teams, Ductal
Echography is a method not operator dependant, it is only
anatomical-dependant.”
Dominique Amy

To my family who believed in my dreams,
to my teachers who helped me accomplish them,
and to my patients who believed in Life.

Contents
1 Breast Doppler Ductal Ultrasonography: Definition, History,
and Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Defi nition and History: Galactography and Ductal Echography . . . . . . . . . . . . . . 1
1.2 The Advantages of the Breast Doppler Ductal Echography . . . . . . . . . . . . . . . . . 3
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Breast Doppler Ductal Echography: Technique of Examination Related
to the Breast Lobar Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.1 General Technical Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2.2 Ductal Echography: Radial US Technique of Scanning . . . . . . . . . . . . . . . . . . . 12
2.2.1 Patient Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.2.2 Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2.2.3 Water-Bag Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.2.4 Steps of Examination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.3 About 3D and 4D US Technique Related to DE . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.4 Usefulness of the Panoramic Scans: SieScape-Type Technique Versus DE . . . . 19
2.5 Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3 Breast Development: Aspects of Doppler Ductal Ultrasonography
of the Normal Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.1 Breast Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.2 Breast Anatomy and Ductal Echography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.3 Types of Normal Breast Anatomy on DE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3.3.1 Thelarche (Mammary Bud) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3.3.2 Young Dense Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
3.3.3 Mixed Adult Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.3.4 Fatty Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.3.5 Lactating Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
4 Sonoelastography in Addition to Doppler Ductal Echography:
Full Breast Ultrasonography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
4.1 Defi nition of the Sonoelastography: Systems of Acquisition . . . . . . . . . . . . . . . 53
4.2 Accuracy of the SE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
4.3 Technique of Sonoelastography: Integration in FBU. . . . . . . . . . . . . . . . . . . . . . 55
4.4 Rendering Sonoelastogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
4.5 Interpretation of the Elastogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
4.5.1 The Elasticity Score Named Upon Ueno/Tsukuba University:
Benign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
4.5.2 Malignant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
4.6 Role of SE in Nonpalpable Breast Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
ix