Eklund G W, Cardenosa G
Department of Radiology, University of Illinois College of Medicine, Peoria.
Radiol Clin North Am. 1992 Jan;30(1):21-53.
The discovery of clinically occult breast cancer creates an exciting opportunity to alter the natural history of one of the major killers of women in our society. The skills required for this endeavor depend on high-quality images that provide the mammographer with sufficient information to construct three-dimensional perceptions recognizable as departures from normal architecture. Altering the natural course of breast cancer depends on early detection. Early detection of breast cancer depends on high-quality imaging techniques. Paramount among the imaging techniques for breast cancer detection is mammographic positioning. Optimal mammographic positioning is achieved by understanding the capabilities of available dedicated mammographic equipment and applying this understanding to take full advantage of natural breast mobility in overcoming various anatomic limitations. Compression of breast tissue, essential for proper parenchymal imaging, is achieved by moving one surface of the breast toward the other. The concept of moving the mobile surface of the breast toward the more fixed and immobile surface has been stressed as an important principle in optimizing the amount of tissue that can be imaged on standard mammographic views. Visualizing the fine details of a lesion or the margins of an area of clinical or perceived radiographic concern may be crucial to determining the need for biopsy. Visualization of such details is best achieved by projecting the suspected lesion into interface with adjacent radiolucent fat through separation of overlapping parenchyma by using spot compression or by tangential imaging against subcutaneous fat. Unique problems require creative, tailored solutions. Such tailoring is made less difficult by understanding and using equipment capability with breast anatomy and mobility. The very small, very large, or very dense breast can be imaged properly with modified techniques. Likewise, the augmented breast, mastectomy site, or axilla can be imaged with specialized techniques. Artistic application of these mammographic positioning principles will be rewarded with high-quality images, fewer missed breast cancers, and more lives saved.
临床隐匿性乳腺癌的发现为改变我们社会中女性主要杀手之一的自然病程创造了一个令人兴奋的机会。这项工作所需的技能依赖于高质量的图像，这些图像能为乳腺造影技师提供足够的信息，以构建可识别为偏离正常结构的三维图像。改变乳腺癌的自然病程取决于早期发现。乳腺癌的早期发现依赖于高质量的成像技术。在乳腺癌检测的成像技术中，乳腺摄影定位最为重要。通过了解现有专用乳腺摄影设备的功能，并将这种了解应用于充分利用乳房的自然活动度来克服各种解剖学限制，从而实现最佳的乳腺摄影定位。对乳腺组织进行压迫，这对获得合适的实质成像至关重要，通过将乳房的一个表面朝向另一个表面移动来实现。将乳房的可移动表面朝向更固定和不可移动的表面移动这一概念，已被强调为优化在标准乳腺摄影视图上可成像组织量的一项重要原则。观察病变的细微细节或临床或影像学上可疑区域的边界，对于确定是否需要活检可能至关重要。通过使用点压迫或与皮下脂肪进行切线成像来分离重叠的实质，从而将可疑病变投影到与相邻透光脂肪的界面上，这样能最好地观察到这些细节。独特的问题需要创造性的、量身定制的解决方案。通过了解并利用设备功能结合乳房解剖结构和活动度，使这种定制变得不那么困难。通过改良技术可以对非常小、非常大或非常致密的乳房进行适当成像。同样，通过专门技术可以对隆乳、乳房切除部位或腋窝进行成像。艺术地应用这些乳腺摄影定位原则将带来高质量的图像、更少漏诊的乳腺癌以及挽救更多生命。
