DOI: 10.3179/jjmu. JJMU.R.130 REVIEW ARTICLE( 第 16 回教育セッション )( 乳腺 ) 抄録, 1 surrounding stroma 2 edematous stroma 2, TDLU,,,.,,,,,, Ultrasound understanding and observation method of normal mammary gland anatomy Ayumi IZUMORI Abstract There are two types of stroma in interlobular stromal fibrous tissue: 1 a surrounding stroma that is densely packed with fibrous connective tissues and surrounds the lobules and an extralobular duct isoechoic and 2 an edematous stroma with loosely packed fibrous connective tissues hyperechoic. The isoechoic structure includes extralobular duct - TDLU in the surrounding stroma. The isoechoic structure shows the running of the duct. Normal isoechoic structures have two types of regularities, i.e., toward the nipple and toward the boundary surface between the lobes, reflecting the course of the mammary ducts. The continuity of the isoechoic structure should be traced by paying attention to these two types of regularities. The site where the isoechoic structure is interrupted in its continuity or disordered in direction should be evaluated for possible pathological changes. Keywords normal breast anatomy,normal mammary gland structure,isoechoic,lobe,deviation from normal はじめに TDLU,,,.,,BMI,,,,,,,,.,,,. Department of Surgery, Takamatsu Heiwa Hospital, 1 4 1 Ritsurincho, Takamatsu, Kagawa 760 8530, Japan Received on February 9, 2018; Accepted on February 26, 2018 J-STAGE. Advanced published. date: May 21, 2018
乳腺内に見える等エコー構造模様の正体 つの小葉外間質,, 2 1 2). 1 2, TDLU 1.. つの小葉外間質の組織学的 画像的特徴 ( ) 膠原線維の密な間質 : 周囲間質 surrounding stroma a. TDLU HE Fig. 1 - ⑴. b. Fig. 2-1. TDLU c. Fig. 3.,,,. Fig. 2-3 c. BMI, Fig. 3.. 等エコー構造の連続性 : 乳管の走行パターンを読む, 1 Fig. 4. 0. 2 mm 12 MHz 小葉 (1) 小葉 (2) (2) (1) 乳管 (2) ( ) 浮腫状で膠原線維が疎な間質 : 浮腫状間質 edematous stroma a. 1 HE. Fig. 1 - ⑵. b. Fig. 1 2 1 surrounding stroma 2 edematous stroma 1 Fig. 2 1 2 3 1 3 6 5,,, 1 3 1 6
2.,,, 1,, Fig. 5 上.,,,,.. 等エコー構造の方向性 : 腺葉の広がりを読む, Fig. 5.,,, Fig. 4, 5 Fig. 3 40 50 80., 1 Fig. 4 1. 1
Fig. 5 2.,,., Fig. 6,., 1, 乳腺の腺葉構造,. 15 20,, Fig. 2 右矢印 4, Fig. 6. TDLU,.,,,, Fig. 6 下右. 乳房超音波検査の実践に必要な知識,,. 新たな正常乳房解剖 観察理解 point 1 2 surrounding stroma TDLU. edematous stroma
腹臥位 /MRI 撮影時 背臥位 /US 観察時 誤った考え方 Fig. 7 MRI. US.., 2 BMI point 2. 観察するもの point 3 point 4, 2. 正常構造からの逸脱部の立体的検出 point 5 point 6 distortion.,,,,,.,., Fig. 7., 鎖骨の1 横指下まで胸骨まで広背筋外縁を確認 270 乳房下溝より3~4 cm尾側から始める Fig. 8 3 4 cm 1 Fig. 7 2,,,,,
Fig. 9., LAFS.,, 観察範囲, Fig. 8.,., lubricant adipofascial system LAFS 3 4), 5) Fig. 9.,,.,, おわりに,.,,,... 1 Izumori A, Horii R, Akiyama F, et al. Proposal of a novel method for observing the breast by high-resolution ultrasound imaging: understanding the normal breast structure and its application in an observational method for detecting deviations. Breast Cancer. 2013; 20:83 91. 2 3. ; 2014.p.14 17. 3 Nakajima H, Imanishi N, Minabe T, et al. Anatomical study of subcutaneous adipofascial tissue: a concept of the protective adipofascial system PAFS and lubricant adipofascial system LAFS. Scand J Plast Reconstr Surg Hand Surg. 2004;38:261 6. 4,,..2006;49:1083 8. 5.. Medical.2017;49:72 6.,