Lesson 3B (Part 2) Flashcards
What are chronic postsurgical US findings that are related to scar formation? (3)
- Retraction
- Dystrophic calcifications
- Fat necrosis
- lipophagic granuloma, oil cyst
What happens if you move a patient with an oil cyst?
It will also move
What can scar formation mimic?
Cancer
How can fat necrosis and dystrophic calcifications appear on the sonogram?
Hypoechoic or hyperechoic irregular mass with acoustic shadowing
What is needed for suspicious lesions? (3)
- Serial ultrasounds
- Mammograms
- Biopsy
What are male breasts mainly composed of?
Fat
What do male breast not have that females do? (2)
- Lobules
2. Coopers ligaments
How do male breasts appear on US? (4)
- Small nipple
- Little subcutaneous fat
- Lack of subareolar glandular development
- Prominent pectoralis major muscle
Gynecomastia
Is the abnormal enlargement of rudimentary male breast tissue
What can gynecomastia be related to?
Steroid abuse or associated with hormonal treatments
- eg) prostate cancer therapies
How can gynecomastia present itself?
As a retroareolar lump with or without pain
How can gynecomastia present itself on US?
Hypoechoic with spiculations radiating away from the nipple
Where does gynecomastia originate?
From the stromal or ductal elements of the breast
How common is male breast cancer?
Very rare
- < 1%
What is the most common cancer for male breasts?
Infiltrating or invasive ductal cancer
How does male breast cancer show on US? (3)
- Microcalcifications uncommon
- Appear spiculated
- Ill defined
How many different shades of gray do you need in order to be delineate fine differences in tissue architecture?
256
How is fat representing on breast images?
Medium gray
What is the mean velocities for highly suspicious malignant breast masses?
25-40 cm/s
What is the mean velocities for benign lesion breast masses?
< 20 cm/s
What are breast US artifacts? (4)
- Bayonet sign
- Mirror image
- Refractive Edge Shadowing
- Partial Volume Effect or Volume Averaging
Bayonet sign
Aspiration needle appears to be broken
- difference in speed of sound between breast and fluid in cyst
Mirror image
Duplication of a complex lesion on both sides of a strong specular acoustic interface
What is the speed of sound in the human body?
1540 m/sec
What is the speed of sound in the breast?
1450 m/sec
What is the speed of sound in silicone breast implants?
1000 m/sec
What does differences in speed cause in the breast?
Artifacts
Refractive Edge Shadowing
Shadows extend from the edges of a cystic breast mass due to refraction
Partial Volume Effect or Volume Averaging
Fill in of cystic structures because echoes are detected outside of central beam axis
