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Understanding Three-Dimensional Breast Imaging

Learn how to think in three dimensions when viewing mammograms, understand descriptive terminology, recognize moving abnormalities, and approximate lesion location. Develop a consistent viewing routine to improve breast tissue analysis.

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Understanding Three-Dimensional Breast Imaging

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  1. CHAPTER 9 Thinking in Three Dimensions

  2. THINKING THREE DIMENSIONALLY • Each views is two dimensional • Combining two views creates a three-dimensional image • Numerous overlapping tissues • Medial structures over lateral • Superior structures over inferior • Each quadrant appears differently

  3. CONSISTENT VIEWING • Develop a routine of viewing • Conforming to same method will familiarize to breast tissue distribution • Established format helps to recognize patterns of pathology • Work with your radiologist

  4. DESCRIPTIVE TERMINOLOGY • Quadrants • UOQ (upper outer quadrant) • UIQ (upper inner quadrant) • LOQ (lower outer quadrant) • LIQ (lower inner quadrant) • Clock-time • Subareolar • Periareolar

  5. DESCRIPTIVE TERMINOLOGY

  6. MAMMOGRAPHIC SUPERIMPOSITION • Each view is a summation of tissue • It is possible to demonstrate an area free of superimposition of other glandular islands or one quadrant free of another

  7. MAMMOGRAPHIC SUPERIMPOSITION

  8. MAMMOGRAPHIC SUPERIMPOSITION

  9. MAMMOGRAPHIC SUPERIMPOSITION

  10. MAMMOGRAPHIC SUPERIMPOSITION

  11. MAMMOGRAPHIC SUPERIMPOSITION

  12. “MOVING” ABNORMALITIES • Nipple is only fixed reference point in breast • Centrally located structures should remain constant • A lesion’s relationship to the nipple will change from view to view • Understanding how a lesion “moves” will help in obtaining correct projection

  13. “MOVING” ABNORMALITIES Three rules • When comparing MLO projection to true lateral, medial lesion will move up on the lateral view • When comparing MLO projection to true lateral, lateral lesion will move down on the lateral view • A central lesion will show no or little movement from MLO to true lateral

  14. “MOVING” ABNORMALITIES

  15. “MOVING” ABNORMALITIES

  16. “MOVING” ABNORMALITIES

  17. “MOVING” ABNORMALITIES

  18. “MOVING” ABNORMALITIES

  19. “MOVING” ABNORMALITIES

  20. “MOVING” ABNORMALITIES

  21. APPROXIMATING LOCATION • Determine whether lesion is medial or lateral to the nipple and its distance from nipple on CC projection • Determine whether lesion is superior or inferior to the nipple and its distance from nipple on MLO projection • A lesion will not change distance from nipple

  22. APPROXIMATING LOCATION Common Errors • Superior and inferior cannot be determined from CC • Medial or lateral cannot be determined from MLO • Superior lesion may be in UOQ or UIQ • If nipple is excessively rotated, lesion may appear to be moving

  23. APPROXIMATING LOCATION

  24. APPROXIMATING LOCATION

  25. APPROXIMATING LOCATION

  26. APPROXIMATING LOCATION

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