Sivarajah Rebecca T, Brown Karen, Chetlen Alison
Department of Radiology, Division of Breast Imaging, Penn State Health, Hershey Medical Center, 30 Hope Drive, Suite 1800, EC 008, Hershey, PA 17033, United States of America.
Penn State Health, Hershey Medical Center, Department of Radiology, H066, 500 University Drive, Hershey, PA 17033, United States of America.
Clin Imaging. 2020 Aug;64:124-135. doi: 10.1016/j.clinimag.2020.03.012. Epub 2020 Apr 1.
Unlike other modalities in breast imaging, breast ultrasound is very operator dependent. Proper characterization and management of breast lesions depends on the knowledge and skill of the radiologist performing the exam. Breast ultrasound optimization continues to evolve as the technology of ultrasound machines improves. The American College of Graduate Medical Education (ACGME) program requirements for graduate medical education in diagnostic radiology recently updated requirements to include competency in ultrasound physics, knobology, and image generation. As trainees are held to high ultrasound optimization standards, practicing radiologists who perform breast ultrasound exams must keep up to date on current breast ultrasound optimization techniques to avoid mischaracterizing and mismanaging breast ultrasound findings. In this paper, ultrasound optimization techniques, including patient positioning, transducer frequency, transducer contact and pressure, depth, gain, focus, tissue harmonic imaging, spatial compounding, dynamic range, speed of sound imaging, Doppler evaluation, and elastography will be described. Multiple ultrasound case examples will be used to illustrate application of these skills. After reading this paper, the reader will be able to apply these techniques to their own breast ultrasound practice, improving characterization and management of breast lesions in their patients.
与乳腺成像的其他方式不同，乳腺超声非常依赖操作者。对乳腺病变进行恰当的特征描述和处理取决于进行检查的放射科医生的知识和技能。随着超声设备技术的改进，乳腺超声优化也在不断发展。美国毕业后医学教育认证委员会（ACGME）针对诊断放射学毕业后医学教育的项目要求最近进行了更新，将超声物理学、操作旋钮技术和图像生成方面的能力纳入其中。由于实习生要达到较高的超声优化标准，进行乳腺超声检查的执业放射科医生必须跟上当前乳腺超声优化技术的发展，以避免对乳腺超声检查结果进行错误的特征描述和处理。在本文中, 将描述超声优化技术，包括患者体位、换能器频率、换能器接触与压力、深度、增益、焦点、组织谐波成像、空间复合成像、动态范围、声速成像、多普勒评估和弹性成像。将使用多个超声病例示例来说明这些技术的应用。阅读本文后，读者将能够把这些技术应用到自己的乳腺超声检查实践中，改善对患者乳腺病变的特征描述和处理。
