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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5791_Библиотеки_им_академика_М_И_Перельмана.pdf
514.1 Grayscale Imaging
cycle, abnormal discharge from the nipple, and
palpable dense breast lesion.
According to Ciatto et al. ( 1994 ) , Marquet
et al. ( 1995 ) , Vetshev et al. ( 1997 ) , and
Tro fi mova ( 2002 ) , US picture of breast carcinoma is quite variable. The basic criteria of
breast cancer with grayscale US are the following: irregular shape of the lesion, heterogeneity
of the echostructure, rough indistinct contours,
and posterior acoustic shadow of various intensity often emerging from posterior or lateral
aspects of the tumor.
Haylenko et al. ( 2005 ) and Sinyukova et al.
( 2007 ) reported microcalci fi cations in 33 % of
cases of breast cancer and note that this sign has
high speci fi city. According to Zabolotskaya
( 2006 ) , microcalci fi cations are registered in 65 %
of intraductal breast carcinoma.
Fig. 4.1 Breast carcinoma.
Nodular type. Grayscale US
52
Fig. 4.1 (continued)
4 Ultrasound Diagnosis of Breast Cancer
Fig. 4.1 (continued)
534.1 Grayscale Imaging
54
Fig. 4.1 (continued)
4 Ultrasound Diagnosis of Breast Cancer
Fig. 4.1 (continued)
554.1 Grayscale Imaging
56
Fig. 4.1 (continued)
4 Ultrasound Diagnosis of Breast Cancer
Fig. 4.1 (continued)
574.1 Grayscale Imaging
58
Fig. 4.1 (continued)
4 Ultrasound Diagnosis of Breast Cancer
594.1 Grayscale Imaging
According to Trufanov et al. ( 2009 ) , breast
carcinoma in grayscale mode is most often
observed as a solitary hypoechoic lesion with
indistinct contours, heterogeneous structure, and
irregular or oval shape, which is elongated in
anterior-posterior direction.
Anechoic and hyperechoic inclusions and
posterior acoustic shadow may be sometimes
de fi ned. Posterior enhancement and lateral acoustic shadows are rare. Malignant breast tumors are
poorly deformed with compression, and their
mobility is quite limited.
While analyzing the shape of a lesion in grayscale mode, attention should be paid to orientation of malignant breast lesion towards the skin
with the prevalence of anteroposterior size.
Breast carcinoma can be bilateral in 3–15 %
of cases. The cancer within the second breast can
arise simultaneously with the tumor of the fi rst
breast (Rozhkova 1993 ) . Multicentric cancer is
Fig. 4.2 In fi ltrative type of
breast carcinoma. Grayscale
U S
60
Fig. 4.2 (continued)
4 Ultrasound Diagnosis of Breast Cancer