Ultrasound of Small Parts and Superficial Organs
Sonography plays an important role in diagnostic evaluation of small parts and superficial organs. FNAC is an important adjunct to sonography in making the diagnosis. High-frequency transducers (7.5–15 MHz) provide penetration up to 5 cm and high-definiti
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Ultrasound of Small Parts and Superficial Organs R.K. Diwakar
Abstract
Sonography plays an important role in diagnostic evaluation of small parts and superficial organs. FNAC is an important adjunct to sonography in making the diagnosis. High-frequency transducers (7.5–15 MHz) provide penetration up to 5 cm and high-definition images with a resolution of 0.7– 1.0 mm. Linear array transducers are preferred to sector transducer because of the wider near field of view and the capability to combine high-frequency greyscale and colour Doppler images. High-frequency transducers (7.5– 10 MHz) provide both deep penetration up to 5 cm and high-definition images with a resolution of 0.7·10·1.0 mm. Linear array transducer is preferably used than the sector transducer because of the wider near field of view and capability of combining colour Doppler images.
7.1
US Imaging of Breast [1]
Sonography has become an important diagnostic tool in the management of breast diseases. Two types of instruments, automated and hand-held, are used for sonography of breast [2]. The lesion in the breast is described as in the anterior/middle/ posterior third of the breast, in the axillary tail or retro-areolar in location. In USG, the breast glandular parenchyma appears homogenously echogenic having hypoechoic zones caused by fatty
R.K. Diwakar Department of Radio-Diagnosis, C.C.M. Medical College & Hospital, Durg, Chhattisgarh, India e-mail: [email protected]
tissue (Fig. 7.1). Breast sonography is an important supplement to mammography. The American College of Radiology’s BI-RADS categorization of mammographic abnormalities [3] is: 1. Negative 2. Benign finding 3. Probably benign (short-term follow-up suggested) 4. Suspicious abnormality (consider biopsy) 5. Highly suggestive of malignancy Breast sonography has become indispensable in the diagnosis and management of benign and malignant process [4]. The mammographic study and interventional procedures should be supplemented with ultrasound.
© Springer Nature Singapore Pte. Ltd. 2018 R.K. Diwakar (ed.), Basics of Abdominal, Gynaecological, Obstetrics and Small Parts Ultrasound, https://doi.org/10.1007/978-981-10-4873-9_7
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R.K. Diwakar
134 Fig. 7.1 Normal echotexture of breast. (a) Right breast. (b) Left breast
a
b
Fig. 7.2 Fibroadenoma of breast
Indications for Breast Sonography [5] 1. To characterize mammographic or palpable masses as solid or cystic 2. To evaluate palpable masses in young (under the age of 30 years), pregnant and lactating patients 3. To evaluate nonpalpable abnormalities for which the mammographic diagnosis is uncertain 4. To evaluate a mass causing asymmetric density in mammography 5. To confirm or better visualize a lesion seen in mammography 6. To guide interventional procedures
Fibroadenoma is the most common benign mass in a woman of 30–35 years of age, and it may be multiple in 10–30% of cases. They are hypoechoic than fibro-glandular parenchyma and isoechoic with fat lobules in the breast (Figs. 7.2 and 7.3). Cysts in the breast are
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