Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Breast Sonography > Sonography > Flashcards

Sonography Flashcards

1
Q

What are the two approaches to breast sonography in the diagnosis of disease?

A
  1. targeted

2. whole breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

🎗 This is when BUS is used to eval only a specific area of the breast, usually as a follow up to mammography.

A

Targeted BUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Besides diagnosis, what’s the other use of BUS?

A

to guide interventional procedures with precise accuracy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many indications for breast sonography can you name? (15 total)

A
  1. eval masses as cystic or solid
  2. f/u to mammo
  3. eval masses in <30 yo women
  4. eval masses in pregnant or lactating women
  5. eval dense breast tissue
  6. eval mass seen in only 1 view in mammo
  7. eval inflammation
  8. eval irradiated breast
  9. eval augmented breast
  10. eval axillary lymph nodes
  11. eval nipple discharge
  12. eval when mammo isn’t possible
  13. serial eval of a benign mass
  14. eval the male breast
  15. guide interventional procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Before beginning the scan, the sonographer should… (4)

A
  1. review priors,
  2. obtain a patient history,
  3. make a visual inspection, and
  4. note any palpable lumps.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

🎗 Describe the ideal patient positioning for BUS.

A
  1. supine or supine oblique

2. with ipsilateral arm above the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

🎗 The right breast is best evaluated in ___ position. The left breast is best in the ___ position.

A 
right = LPO (left posterior oblique)
left = RPO (right posterior oblique)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

🎗 The ___ aspect of the breast is effectively evaluated with the patient in supine position.

A

medial aspect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

🎗 For ___ patients, lateral lesions may require steep oblique or decubitus positions.

A

larger breasted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

🎗 How much transducer pressure should be applied during scanning and why?

A

moderate, helps eliminate artifacts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

🎗 What scan planes are used in BUS?

A

sag & trans and rad & anti-rad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

🎗 Which scan plan is parallel with the ducts?

A

Radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

🎗T/F? Radial is perpendicular to the ducts.

A

FALSE, anti-radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

🎗 Which scan plane does AIUM recommended for BUS?

A

Radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe 3 o’clock transverse in rad/anti-rad.

A

3 o’clock radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe 6 o’clock transverse in rad/anti-rad.

A

6 o’clock anti-rad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe 12 o’clock sagittal in rad/anti-rad.

A

12 o’clock radial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe 9 o’clock sagittal in rad/anti-rad.

A

9 o’clock anti-rad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If you find a lesion while scanning in sag/trans, you should…

A

switch to rad/anti-rad to assess the ducts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does SA denote in a BUS label?

A

subareolar region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does AX refer to in a BUS label?

A

axillary region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

123 Method: Does it indicate distance or depth?

A

distance from the nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

123 Method: Which number is closest to the nipple?

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ABC Method: Does it indicated distance or depth?

A

depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ABC Method: Which letter is deepest?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

🎗 Why use a stand-off pad?

A

to improve focusing and greater detail in the superficial layers of the breast when using a linear probe (not matrix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

🎗 A stand-off pad improves imaging of: (6)

A
  1. superficial tumors or cysts
  2. superficial vessels
  3. superficial ducts
  4. skin lesions
  5. skin thickening
    * * 6. scanning surgical specimens**
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

🎗 What’s the ideal stand-off pad thickness for breast imaging?

A

1 cm. This places the elevation plane focus of a 10MHz transducer at approx 0.5 cm depth within the breast.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

🎗 T/F? Younger women are more likely to have tissue that appears hyperechoic.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

🎗 T/F? Older women tend to have tissue that appears hyperechoic.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

🎗 T/F? Lactating women will have breast tissue that appears more hyperechoic.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

🎗 T/F? Very thin patients will have breast tissue that seems more hyperechoic.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

🎗 What are the three major types of breast tissue seen in BUS?

A 
Fat (superficial, intraparenchymal, retromammary)
Epithelium (TDLU and acini)
Stromal Tissue (loose - intralobular and periductal, dense - interlobular and cooper's ligaments)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Breast skin: thickness is ___ and __echoic.

A

0.5 - 2mm, hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Breast fat is ___echoic.

A

iso- or midlevel. All structures use fat’s echogenicity as a reference.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Cooper’s ligaments are ___echoic and may produce this artifact.

A

hyper-, shadowing (because they’re so dense)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Glandular Epithelium is ___echoic and made up of ___.

A

iso to mildly hypo-, TDLUs and acini

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

🎗 Dense fibroglandular tissue is ___echoic and a combo of ___ tissues.

A

hyper-, glandular epithelium and connective tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Lactiferous ducts are ___echoic unless they’re fluid filled. Then they’re __echoic.

A

hypo-, an-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Pectoralis muscles are ___echoic and found ___.

A

hypo- with hyper- striations, deep to the retromammary layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Ribs are ___echoic with this artifact and found ___.

A

hyper- with shadowing, deep to retromammary layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

🎗 Lymph nodes are ___echoic and ___ shaped.

A

hypo- cortex and hyper- hilum, kidney shaped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Calcifications are ___echoic.

A

markedly hyper-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Cysts are ___echoic if simple and ___echoic if complicated.

A

an-, hypo-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Benign lesions are ___echoic with similar echogenicity to __ and ___ tissues.

A

mildly hypo-, iso-, or mildly hyper-

fat and epithelium

46
Q

Malignant lesions are ___echioc and general __ echogenic than benign lesions.

A

mild to markedly hypo-, less echogenic

47
Q

T/F? BUS cannot distinguish between benign and malignant.

A

true

48
Q

T/F? Benign diseases tend to cross fibrous planes.

A

false

49
Q

T/F? 🎗 Malignant diseases tend to cross fibrous planes.

A

true, growing toward the skin

50
Q

Cancers use these two systems to infiltrate the breast.

A

superficial venous and lymphatic

51
Q

Name three dynamic imaging opportunities.

A
  1. compression
  2. echo-palpitation
  3. fremitus
52
Q

🎗 How does a cyst respond to compression?

A

will change shape

53
Q

🎗 How does a benign lesion respond to compression?

A

benign lesions tend to be soft (lipoma) so will likely change shape
internal echoes may become more uniform

54
Q

🎗 How does a malignant lesion respond to compression?

A

malignant lesion tend to be hard - will not change shape

55
Q

T/F? Debris within cysts or ducts may be better visualized with compression.

A

true

56
Q

🎗 Echo-palpitation is a technique used to ___.

A

isolate a palpable mass.

57
Q

Echo-palpitation allows the sonographer to ___ and to ___ simultaneously.

A
  1. be sure to be scanning the correct structure

2. assess the mobility of the lesion

58
Q

Define ‘fremitus’.

A

the vibration of tissues during speech

59
Q

Breakdown fremitus maneuver in BUS

A
  1. isolate tissue in question
  2. Engage power doppler
  3. have patient talk or hum
  4. normal tissue will vibrate creating a signal
  5. tumors do not vibrate or create a signal
60
Q

Fremitus maneuver is especially helpful evaluating: (5)

A
  1. normal fat lobules
  2. normal tissue vs isoechoic lesion
  3. ill-defined borders
  4. non visualized posterior margin
  5. benign vs malignant characteristics
61
Q

What’s the main benefit of using 3D breast imaging?

A

using the coronal plane to identify spiculation

62
Q

What are the limitations of hand-held ultrasound? (3)

A
  1. operator skill level
  2. exam variability
  3. long exam times
63
Q

What are the benefits of Automated Breast Ultrasound? (4)

A
  1. decreased reliability on operator skill level
  2. images the entire breast
  3. displays coronal plane
  4. decreased exam time
64
Q

Name the three sonographic features of benign breast disease.

A
  1. rounded (cysts)
  2. oval/ellipsoid (benign tumors)
  3. horizontal orientation (wider than tall)
65
Q

🎗 T/F? Benign tumors tend to grow within or along the tissue plane.

A

true

66
Q

Smooth, well-defined, and circumscribed margins indicate that the tumor is …

A

… displacing adjacent tissues rather than invading them.

67
Q

Why is a pseudocapsule indicative of a benign process?

A

Pseudocapsules are caused by the compression of adjacent tissues. Malignant processes would invade instead of compress.

68
Q

What kinds of echogenicity suggest benign breast disease? (4)

A
  1. anechoic (cyst)
  2. hyperechoic (lipoma)
  3. *isoechoic (solid benign)
  4. *homogeneous
    * sometimes
69
Q

Name two artifacts that suggest benign breast disease.

A
  1. acoustic enhancement

2. edge shadowing

70
Q

Enhancement artifact offers good ___ of the posterior tumor wall.

A

visualization

71
Q

What kind of doppler flow do benign solid masses demonstrate?

A

little to none

maybe just a stalk/stem or feeder vessel

72
Q

Ducts generally measure ___ mm and ___ in size as they run toward the nipple.

A

less than 3 mm; increase

73
Q

🎗 What normal conditions might cause duct dilation or ectasia?

A
  1. lactation
  2. 3rd trimester
  3. peri-menopausal changes
74
Q

What abnormal conditions might cause duct dilation or ectasia?

A

mastitis, fibrocyctic changes, papillomas, ductal carcinomas, papillary cancinomas

75
Q

T/F? Large calcifications are typically malignant.

A

FALSE, they are a benign characteristic

76
Q

Scarring, necrosis, hemorrhage, cysts, or fibroadenomas are benign causes of ___.

A

calcifications.

77
Q

🎗 As the lymph node becomes more fatty, the __ thins and the __ is more prominent.

A

cortex; hilum

78
Q

Size of a normal lymph node?

A

less than 2 cm

79
Q

Normal cortical thickness of a lymph node?

A

less than 3 mm

80
Q

T/F? Lymph nodes have low resistive doppler waveforms.

A

true

81
Q

Name the two sonographic features of malignant breast disease.

A
  1. irregular shape

2. vertical orientation

82
Q

🎗 The vertical orientation of malignant disease might also be described as…

A

taller-than-wide
AP>Length
Depth>Width

83
Q

🎗 Why are malignant processes vertical instead of horizontal?

A

Because they’re invading through tissue planes

84
Q

Describe margins with multiple small (<2mm) lobulations.

A

microlobulation

85
Q

Describe obscured or indistinct margins.

A

ill-defined

86
Q

🎗 Describe irregular jagged margins.

A

angular (highly sensitive for malignancy)

87
Q

Describe margins with straight lines which radiate from the center of a tumor.

A

spiculated (most specific for malignancy)

88
Q

🎗 Describe the extension of a tumor into a duct coursing TOWARD the nipple.

A

duct extension

89
Q

🎗 Describe the extension of a tumor into a duct coursing AWAY from the nipple (tends to involve multiple ducts).

A

branch pattern

90
Q

What plane must you be in to assess tumor extension?

A

radial

91
Q

T/F? Malignant processes will have a thick, echogenic border.

A

true

92
Q

🎗 What’s desmoplasia?

A

The fibrotic host response to tumor invasion (the development of a thick border to try and contain the disease)

93
Q

A malignant process tends to be __echoic.

A

mildly to markedly hypoechoic

94
Q

T/F? Malignant processes will be homogeneous.

A

FALSE, heterogeneous (excepting complex cysts and fibroids)

95
Q

🎗___ may cause limited or lack of visualization of the posterior tumor wall.

A

shadowing

96
Q

T/F? Most solid, malignant tumors demonstrate some degree of shadowing

A

true

97
Q

🎗 What common benign structure in the breast tissue may cause shadowing?

A

cooper’s ligaments

98
Q

What less common benign structures may cause shadowing? (3)

A

calcified fibroadenoma, radial scar, fat necrosis

99
Q

This is the ability of a malignancy to develop new blood vessels

A

angiogenesis

100
Q

What benign phenomenon may mimic a malignancy’s increased blood flow?

A

inflammation

101
Q

Is a malignancy’s increased blood flow on the periphery or internal to the structure?

A

BOTH

102
Q

T/F? Conventional and power doppler are reliable ways to distinguish benign from malignant.

A

FALSE

103
Q

🎗Which usual layer do tumor vessels lack?

A

basement membrane or adventita

104
Q

Name 4 examples of malignancy crossing into superficial planes.

A
  1. skin dimpling
  2. skin thickening
  3. nipple retraction
  4. retraction of cooper’s ligaments
105
Q

T/F? malignancies only cross into superficial planes not deep ones.

A

FALSE

106
Q

Which benign processes interrupt tissue planes?

A

inflammation and trauma

107
Q

T/F? Sagittal scanning should be performed to assess duct extension and branch pattern

A

FALSE, radial

108
Q

Are the microcalcifications associated with malignancy more likely to be seen in ultrasound or mammography?

A

mammography

109
Q

At what measurement is a lymph node considered enlarged?

A

greater than 2 cm

110
Q

At what measurement is a lymph node considered to have cortical thickening?

A

greater than 3 mm

111
Q

What three qualities do malignant lymph nodes possess?

A
  1. loss of fatty hilum definition
  2. microcalcifications
  3. high resistive doppler waveform
112
Q

🎗 As a lymph node becomes cancerous, it generally ___ and loses ___.

A

enlarges, loses definition of the fatty hilum

Breast Sonography (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions