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CT Abd Epiploic Appendagitis
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Diffuse periosteal reaction
Signs in Uroradiology
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MRI Breast Indications
CT Head Cerebellar Mass
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Diagnostic mammography
Screening mammography
Mammo Pearls
ACR Appropriateness Criteria Breast Cancer Screen
AVM types
CT Orbits
CT Abd NL
Chiari Malformations
Vesicoureteral Reflux (VUR)
Elbow
XRAY Abdominal Series

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Mammo Pearls

  • Max dose to glandular tissue is 0.3 rad (3 mGy).
  • Mammo: 90% sensitive to find breast cancer.
  • Greatest proportion of breast cancers occur in upper outer region of the breast.
  • Dense breasts have 4x higher risk for developing cancer.
  • The USPSTF does NOT endorse yearly screening mammo for any age range for US women.
  • Males need bilateral mammo even if unilateral complain.
  • Rotter’s node: interpectoral LN met from breast ca.
  • 10% of DCIS may present as a mass.
  • Well circumscribed masses: M&M - Medullary and Mucinous IDC.
  • Normal lymph node cortical thickness < 3 mm.
  • Radial Scar (Complex Sclerosing Lesion) is associated with Tubular IDC.
  • Pregnancy-associated breast ca occurs during the pregnancy or within 1 year of childbirth.
  • A group of microcalcifications is defined as ≥ 5 calcifications within < 1 cc volume of breast tissue or about 1 cm. "Regional distribution" is used for calcifications spanning > 2 cm if not thought to conform to a duct and its branches. "Segmental distribution" when the calcifications represent an intraductal process involving a duct and its branches to convey a higher level of concern for possible ductal carcinoma in situ.
  • The parasternal and inframammary fold are the 2 most common locations for skin calcifications.
  • Terminal ductal lobular unit (TDLU) proliferation occurs during the postovulatory (secretory) phase of menstrual cycle, which is why you would want to perform breast MR imaging in the proliferative phase (days 6-12) when the breast TDLU is quiescent to reduce background enhancement. Note that the "proliferative phase" of the menstrual cycle is referring to the uterus, not the breast TDLU. The other answers (pregnancy, exogenous hormones, late adolescence) are also general phases in life that the TDLU will also proliferate (and make breast MR imaging less sensitive due to physiologic enhancement).
  • Ectopic terminal duct lobular units (TDLUs) are present in both the premammary and the retromammary zones. Ectopic ducts and TDLUs (or remnants secondary to physiologic fatty atrophy of breast maturation) occur in the pre- and retromammary spaces, which can give rise to malignancies that may present as focal or developing asymmetries in these zones.
  • PASH: Pseudoangiomatous stromal hyperplasia is not typically associated with calcifications.
  • A simple cyst is defined as anechoic with imperceptible wall and posterior enhancement.
  • There are 3 anatomic zones in the breast: premammary, mammary, and retromammary. The anterior and posterior mammary fascia surround the mammary zone. Suspensory ligaments are formed by 2 leaflets of the mammary fascia, which connect the mammary fascia either to the dermis in the case of anterior suspensory ligaments (Cooper ligaments) or to the chest wall in the case of the posterior suspensory ligaments.
  • When used in screening, tomosynthesis helps the radiologist avoid recalls due to superimposition of tissue. Tomosynthesis also helps identify subtle architectural distortions that would otherwise be inapparent on conventional 2D mammography.
  • The pectoralis major is immediately deep to superior in 2/3rd of breast tissue. The smaller clavicular division originates from the medial half of the clavicle, and the larger costosternal division originates from the sternum and 2nd-6th costal cartilages. It inserts into greater tuberosity of humerus.
  • The proliferative phase includes days 3-14 of menstrual cycle and is also known as the follicular phase. This is the ideal time for breast imaging (especially important in MR to reduce background enhancement).
  • Galactocele should be considered in a patient with a relatively recent history of lactation or even several years post lactation. Galactoceles contain inspissated milk and fat and may demonstrate a characteristic fat-fluid level on lateral mammography, which is pathognomonic.
  • The mammary gland consists of about 20 lobes, suspended by connective tissue, surrounding by adipose tissue. Each lobe is connected by its own segmental (lactiferous) duct to a lactiferous sinus, which lies just behind the nipple.