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VIGNAL Philippe MD Paris France
Th Stavros, Denver




Breast
The sonographic solid nodules algorithm
The BIRADS characterization


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--- Arabic
Breast The sonographic solid nodules algorithm The BIRADS characterization
Here some examples

Principe de la classification Birads adaptée à l'échographie des nodules solides du sein
Voici quelques exemples

 


 


 

Click on the image below
Cliquez sur les images en bas

 

 

Video

tumor puncture
Ponction tumorale


(1.03M

Harmonic scan
Harmonique


(1,4M)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

With anatomicopathologic section avec la coupe anatomopathologique
Diagnosis :Breast tumor Birads 5 Diagnostic :Tumeur du sein : Birads 5 ____

 

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Français
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Arabic

Hyperechoic mass ( lipomas)

Lymph node

Silicon granuloma

 

 

 

Gently lobulated, wider than tall completely encompassed by a thin echogenic capsule

 

Elliptical, wider than tall completely encompassed by a thin echogenic capsule

 

 

 

Video
Click on the image below (1.03Mb)


A complete ( long and short axis) thin echogenic capsule must be present.

 


A partial capsule is inadequate proof of benignity

 


Where is the capsule ?

 

 

   

Microlobulations Se 71% PPV 40%

   

Angular margins Se 28% PPV 80%
 

 
Markedly hypoechoic Se 48 VPP 41%
 

Branch pattern Se 3.6% PPV 14%
 
   

 

duct extension Se 3.6 PPV 100
 

 

 

 

 



Echogenic halo (h: 35%)

 

Echogenic halo: value of harmonics
Click on (1.4Mb)

 

 
  Spiculations Se 43% PPV 97%

 

   

Taller than wide Se 14 PPV 80%

   

 

Why taller than wide is specific of malignancy ?  
Because the breast vasculature is perpenducular to the skin
   

 

   
Shadowing Se 64% PPV 29%
 

 

 

Attention : false positive

Move the probe …

heeling and toeing in the long axis, rocking In the short axis

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