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mammography > Endterm > Flashcards

Endterm Flashcards

1
Q

Goal for mammographic positioning.

A

Bring back the breast to it’s true anatomical position (with nipple perpendicular to the chest
wall)

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2
Q

Different shapes of breast

A

Perfect breast, small breast, sagging breast, large breast, tubular breast, swooping breast pigeon breast, snoopy breast

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3
Q

When positioning for mammography we need to bring the breast back to it’s normal position

Normal
Grade 1-
Grade 2-
Grade 3-
Pseudoptosis-
Parenchymal maldistribution-

A

Mild sagging
Moderate sagging
Significant sagging
Lower breast sagging
Unusual shape

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4
Q

Breast landmarks

A

Perimeter
Posterior nipple line (PNL)
Pectoralis muscle

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5
Q

Perimeter of the breast
A.
B.
C.
D.
E.

A

Lateral
Inferior
Medial
Superior
Extension of superior border

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6
Q

Pectoralis major muscle

A

Clavicular head
Sternocostal head

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7
Q

__ used for positioning and clinical image analysis

A

Pectoralis

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8
Q

PNL measurement of CC should be within
__ measurement on the MLO

A

1cm

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9
Q

PNL used for positioning

A

Elevate breast so that pnl is as close as possible to perpendicular to the chest wall

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10
Q

is lower boundary of the breast, the place where the breast and the chest meet.

A

inframammary crease or inframammary line

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11
Q

Folds in the IMF

A

Horizontal fold is the medial breast
Vertical is the lateral breast

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12
Q

to enable proper visualization of the nipple-areolar complex and to avoid mistaking the nipple for a mass.

A

nipple must be depicted in profile on at least one view

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13
Q

Routine views in mammography

A

Cc- craniocaudal
Mlo-mediolateral oblique

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14
Q

Additional views

A

Lateral view- ml and lm
Tangential view
Cleavage view
Axillary view
Magnification view
Xccl- exaggerated cc lat
Xccm- exaggerated cc med
Jigsaw
Othter techniques

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15
Q

✓ Include maximum amount of the breast tissue in the axial/transverse plane

✓ Visualization of the medial breast tissue (cleavage) if possible

✓ Visualization of the pectoralis muscle on approximately 30% of all CC’s.

A

Craniocaudal

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16
Q

Elevate the breast so the __ is perpendiculat to the chest wall and __ the breast on both hands

A

Pnl, pull

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17
Q

1 handed plop- __ cm
2 handed pull- __ cm

A

12.5 cm
14.8 cm

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18
Q

Mobile border of the breast pulled forward

A

Lateral

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19
Q

• CR __

• Film Tray to height of inframammary crease

•

• __ and __ smoothed out

• __ on axillary side

A

perpendicular

Nipple in profile

Wrinkles folds

Marker

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20
Q

The breast is divided by depth into __, __, and __ tissues:
as seen in the lateral (A) and craniocaudal (B) projections.

A

anterior, middle, posterior

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21
Q

if possible, without sacrificing breast tissue
• Nipple may not be centered due to lateral or medial fullness of the breast, which should be
noted on the hx sheet.

A

Nipple must be centered on cc view

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22
Q

✓Inclusion of all breast tissue within perimeter

✓ Pectoral muscle fully visualized

✓ Tissue well-separated

✓ Tissue back to retromammary space fat space

✓ Inframammary fold is present

A

Mediolateral oblique

23
Q

• Cassette (IR) angled__ (depends on the body habitus)
• __ for small breast and longer thorax
• __ for larger breast and short thorax
• __ = axilla
• __ at Axilla

A

45 °
Steeper angle
Lesser angles
Top of IR
Marker

24
Q

Ss in mediolateral oblique

A

Visualization of pectoral muscle
Wide margin of axilla
Visualize down to level of PNL

25
Q

The __ is really not part of the breast… however it serves as important anatomic landmark for positioning and film evaluation

A

pectoralis muscle

26
Q

Problems at Mediolateral oblique (MLO)

A

No visualization of IMF
overlapping fold in IMF
Breast drooping

27
Q

Do you see a __ at the level of the posterior nipple line on the mlo mammograms?

A

Convex-appearing pectoralis major muscle

28
Q

Is there __ in the measurements between the nipple and the pectoralis major muscle (ie the PNL) on cc and mlo view?

A

Less than or equal to 1cm difference

29
Q

Is the __ in at least one view?

A

Nipple in profile

30
Q

Is the tissue well compressed with the nipple in an “__” and “__” orientation (eg, perpendicular to the chest wall)

A

Up and out

31
Q

Is the __ open on the MLO view?

A

Inframammary fold

32
Q

Is the breast pulled straight __ on the cc view? Is. The view not __ or __ exaggerated?

A

Foward, medially, laterally

33
Q

• The IR is placed up against the sternum and the film is taken in a true lateral projection.

• This view allows the medial breast to be closest to the film and the medial breast to be more carefully evaluated.

• properly positioned LM with the breasts separated so top edge of the IR is centered on midtsternal line and the width of IR pressing against the contralateral breast

• improperly positioned LM with breast separated so middle of IR is centered on midsternal line thus excluding deep medial breast tissue on side you are imaging

Criteria:
• The nipple must be in profile.
• Good visualization of the inframammary area
• A short wedge of pectoral muscle at the chest wall edge
• Breast tissue should be well compressed and lifted up and out at 90 degrees to the chest wall.

A

Lateral view

34
Q

Degree of angulation in mediolateral and lateromedial view?

A

90 degree

35
Q

Superior or inferior orientation to the nipple

A

Lm- superior
Ml-inferior

36
Q

• When doing MLO you showed the lateral breast in better detail
• In 90 deg LM shows the medial breast in better detail.
• In 90 deg ML shows the lateral breast in better detail.

A

Lateromedial view

37
Q

Lateromedial advantages

A

✓ The hardest part of the breast being image (and the area often missed on the MLO) is the posterior medial breast.
✓If done properly, (off-setting the IR into the contralateral breast) you will be able to get deeper against the chest wall.

38
Q

The use of lateral views

A

• Shows the effect of gravity on air-fluid levels
• Used a “tie-breaker” view / triangulate lesions
• Provides visualization of the 12:00 and 6:00 areas of the breast

39
Q

➢ also called “valley view”
➢ posteromedial portion of both breasts (the “valley” between the two breasts) by placing them on the cassette at the same time and pulling them anteriorly.

SS:
✓Visualization of the medial breast in CC projection
✓View on the medial – inner portions of both breast.

Limitation/s:
• Can be difficult on thin women

A

Cleavage view

40
Q

✓Skim the area of interest
✓Prove the existence of dermal calcifications.
✓Enhanced visualization of the palpable masses that may otherwise be superimposed on the glandular breast tissue.

This views are useful to differentiate intracutaneous radiopaque particles in a tattoo from intraparenchymal microcalcifications.

✓Mammographic findings close to the skin such as masses, microcalcifications, skin-dimpling or shaded areas always pose a problem of differential diagnosis.

May also use:
✓ Use spot compression paddle (can be magnified)

A

Tangential view

41
Q

Angle of obliquity

A

The angle of obliquity will depend on the location of the abnormality.
✓Draw an imaginary line from the nipple to the abnormality.
✓Turn the c-arm so that the IR parallels this line.

42
Q

Place the __ on a palpable mass or on the area identified by localizing skin calcifications

A

BB

43
Q

✓A small lead-free or non- metallic pellet “__” is used to indicate the nipple.
✓A __is used to indicate a skin lesion such as a mole
✓ a __ is used to indicate a palpable abnormality.

A

BB
circular radiopaque “O”
radiopaque triangle

44
Q

Different types of BB

A

N-Spot Pellet-nipple
O-Spot Circle-mole
S-Spot Line-surigcal scar
A-Spot Triangle- palpable mass
Altus Square- area of concern or pain

45
Q

✓It is named after G.W. Eklund who introduced this new technique in 1988.
✓Eklund modified compression technique is a technique which can be used for patients with augmented or reconstructed breasts post mastectomy.

Limatations:
✓It is used in addition to the routine two projection mammogram and cannot be used as a substitute as it does not image the most posterior portions of the breast.

A

Eklund technique/ displacement view

46
Q

✓(also known as a “Cleopatra view“) is a type of supplementary mammographic view.
✓This projection is performed whenever we want to show a lesion seen only in the axillary
tail on the MLO view.

SS:
• Used to visualize the axillary tail
• Compresses the lateral aspect close to the pectoral muscle

A

Axillary tail view

47
Q

To demonstrate the tissue on a large breasted woman with avdegree of overlap from film to film so that no tissue is missed, it is necessary to divide the areas of breast tissue.

A

Jigsaw

48
Q

Jigsaws
• In some protocol, the CC view is divided into and •With MLO view:

A
  1. lateral.
  2. medial portion
  3. front/nipple area.
  4. pectoral area
  5. inferior portion
  6. anterior/nipple area
49
Q

is a type of exaggerated CC view.
✓ It is particularly good for imaging the medial portion of the breast.
✓ In this view, the medial portion of the breast is placed forward. A negative 15° tube tilt is
suggested.
✓ An optimal __ view requires the most medial portion of the breast and the nipple in
profile to be clearly displayed.

A

Exaggerated ccm view (XCCM)

50
Q

is a type of exaggerated CC view.
✓ It is particularly good for imaging the lateral portion of the breast.
✓ In this view, the lateral aspect of the breast is placed forward. One rationale of performing this view is that many cancers are located in the lateral aspect of the breast.

•It is often done when a lesion is suspected on MLO View but cannot be seen on the CC view.

A

Exaggerated ccl view (XCCL)

51
Q

is an additional mammographic view performed by applying the compression to a smaller area of tissue using a small compression paddle, increasing the effective pressure on that spot.

A

Spot view (spot compression view or focal compression view)

52
Q

Difference between full compression paddle and spot compression paddle

A

Uniform density across image in full compressiom paddle while better compression over small area in spot compression paddle

53
Q

This technique is performed with an additional device that consists of a spot cone incorporated
in the top of a plane support, together with a standard spot compression paddle.

A

Double spot compression view

54
Q

in mammography is performed to evaluate and count microcalcifications and its extension
(as well the assessment of the borders and the tissue structures of a suspicious area or a mass) by using a magnification device which brings the breast away from the film plate and closer to the x-ray source.
✓ This allows the acquisition of magnified images (1.5x to 2x magnification) of the region of interest.

A

Magnification view

mammography (3 decks)

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