BI-RADS for Ultrasound




(1)
Chennai Breast Centre, Chennai, India

 




Breast Imaging Reporting and Data System (BI-RADS) for Ultrasound (Based on the 5th Edition of ACR BI-RADS)


The consistent use of BI-RADS descriptors for breast ultrasound as for mammography helps in lesion assessment and communication with physicians and patients.


Report Relevant Points






  • The indication for the examination


  • The scope and technique of breast ultrasound


  • Description of breast composition


  • Clear description of relevant findings


  • Comparison with previous studies if available, clinical exam and mammogram or MRI


  • Composite reports


  • Assessment


  • Management recommendation


Indication of Examination


The most common indication to perform an ultrasound scan is to confirm and characterize lesions seen on mammogram or as second look after an MRI scan. Very young women, pregnant and lactating women may also have breast ultrasound as the first imaging technique. Breast ultrasound is also used to do guided core biopsy or wire localization.


Breast Composition


Breast composition should be mentioned when ultrasound is done as a screening examination.

Three US descriptors for composition have been described. Breast tissue composition is determined by echogenicity of the fat. Subcutaneous fat is medium gray and relative to this the fibroglandular tissue is lighter gray.

1.

Homogeneous backgraound echotexture – fat

 

2.

Heterogeneous background echotexture – fibroglandular

 

3.

Heterogeneous background echotexture

 


Clear Description of Findings



Masses


A mass occupies space and should be seen in two different projections. Characterization of the mass using morphological descriptors of shape, margin, orientation, boundary zone, echotexture, posterior acoustic features, and techniques like vascularity and echogenicity should be done.


Mass: Shape






  • Oval

    Elliptical or egg shaped (may include 2 or 3 undulations, i.e., “gently lobulated” or “macrolobulated”)




  • Round

    Spherical, ball-shaped, circular, or globular




  • Irregular

    Neither round nor oval shape


Mass: Orientation






  • Parallel

    Long axis of lesion parallels the skin line (“wider than tall” or horizontal).




  • Not parallel

    Long axis, not oriented along the skin line (“taller than wide” or vertical, includes round)


Mass: Margin






  • Circumscribed

    A margin that is well defined or sharp, with an abrupt transition between the lesion and surrounding tissue




  • Not circumscribed

    The mass has one or more of the following features: indistinct, angular, microlobulated, or spiculated




  • Indistinct

    No clear demarcation between a mass and its surrounding tissue




  • Angular

    Margins with sharp corners, often forming acute angles


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May 30, 2017 | Posted by in Uncategorized | Comments Off on BI-RADS for Ultrasound

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