Pratica di Shadowing: Breast Ultrasound Normal Vs Abnormal Image Appearances Comparison | BI-RADS Classification USG - Impara a parlare inglese con YouTube

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hello everyone this is dr sam and today we will  study breast ultrasound image appearances here we
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hello everyone this is dr sam and today we will  study breast ultrasound image appearances here we
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have the images of normal breast the uppermost  layer is the skin this is the hyperechoic
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layer and below that is the subcutaneous zone it  is usually hypoechoic as compared to the tissues
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below and the largest region is the mammary  zone it usually has mixed echogenicity most
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of the pathologies occur in this zone and this  hyperechoic area is the fibro glandular tissue
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these hyperechoic slanted or diagonal lines  are cooper ligaments this striated structure
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is the pectoral muscle the retro memory zone lies  between the pectoral muscle and the memory zone
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usually it appears smaller because it  is compressed due to probe pressure
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and this shadowing over here is due to the  rib here we have more images of normal breast
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we can see the three zones and the fibro  glandular tissue which is hyperechoic usually the
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retro memory zone is below this fibroglandular  tissue but it is not always the case
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breast pathologies can be classified  by using a system known as bi-rads
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it stands for breast imaging reporting and  data system in total it has seven categories
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in bi-rads 0 we need further images we need more  scans such as mammograms or ultrasound scans
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bi-rads 1 is for normal breast tissue  where there is no mass or no distortion
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no lesion both these images are by reds one
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a simple cyst will appear as an anechoic structure  with posterior enhancement the cyst will be round
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or ovoid with a smooth hyperechoic border it  is classified as bi-rads 2 which is benign
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a complicated cyst will have fat  fluid levels and internal echoes
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these are fat fluid levels the low density  fluid is at the top and the high density fat
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is at the bottom now these cysts may  resemble malignant lesions that is why a follow-up is needed examples of complicated  cysts include oil cysts and galactocysts
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a fibroadenoma is a benign tumor which will  appear as a hypoechoic round or ovoid mass
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it may have a hyperechoic rim known as a pseudo  capsule and it has a parallel orientation it is
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wider than tall you can see it is wider instead  of being taller this is a sign of benign lesion
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it is classified as bi-rads 2 which is benign  however routine screening mammography should be
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done here we have another image of fibroadenoma  it has a smooth border it may have calcifications
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you can see the pseudo capsule here and it has  a parallel orientation it is wider than tall
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a lipoma will appear as a hyperechoic rounded mass  usually hyperechoic rounded masses are benign it
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has a bi-rads score of two despite this appearance  routine screening mammography should be done
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hyperechoic masses that are ovoid rounded or well  circumscribed are usually benign another benign
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feature is the parallel orientation in which it  is wider than tall examples include angio lipoma
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hemangioma hamartoma they usually appear as  hyperechoic masses with a hyperechoic border
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here we have an image of intra memory lymph  node they have a hypoechoic outer cortex
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this is the cortex and a  hyperechoic central mediastinum
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which is hyperechoic usually due to  fat they are classified as bi-rads 2
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a neurofibroma is a rare benign tumor
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which appears as a hypoechoic mass with posterior  enhancement now it is very tricky because it resembles a cyst so it can be misdiagnosed  very easily but it is a rare lesion
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a sebaceous cyst is a complex cyst  which is present closer to the skin
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here you can see it is present just below the  skin and it is even involving the skin so this superficial location can help us in diagnosing  sebaceous cyst it is classified as bi-rads 2
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a simple cyst containing a  small hyperechoic calculus
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is usually a milk of calcium  cyst these cysts are also benign
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egg shell calcifications are small calcifications  which may have shadowing if they are a bit dense
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they have a bi-rads score of  two complex cysts are rated as bi-rads 3 because they need a follow-up  exam usually thin hyperechoic septations
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are benign but they still need a follow-up  so that is why it is rated as bi-rads 3
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clustered microcysts will have a group of cysts  clustered together the diameter is less than three millimeters and septations may be present it is  rated as bi-rads 3 because follow-up is required
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fat necrosis has a variety of appearances  in the acute phase the lesion is new so it may appear as a hyperechoic  lesion due to edema fat necrosis
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appearances overlap with malignant lesions so a  follow-up is required so it is rated as bi-rads 3
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fat necrosis enters late stage after 1.5 years
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it will have calcified walls which  give posterior acoustic shadowing
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now we move on to bi-rads categories which have  chance of malignancy bi-rads 4 has 3 sub-categories
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in 4a the chance of malignancy is between 2 to 10  percent b is 10 to 49 and 4c is 50 to 94 percent
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bi-rads 5 has greater than 95  percent chance of malignancy
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and bi-rads 6 is a biopsy proven malignancy  usually hypoechoic masses with irregular walls or a speculated appearance are malignant  and they have a taller than wide orientation
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here we have a case of lymph node metastasis
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we are comparing it with a non-malignant  lymph node the cortex is very thick
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which gives it an abnormally hyperechoic  appearance it is usually a sign of malignancy
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intraductal papilloma is not very common its  appearance usually involves dilated ducts
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and a well-defined nodule it is rated  as bi-rads 4 and biopsy is advised
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intracystic papillary carcinoma consists of  a complex cyst with a thick mural based nodule
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this nodule will be attached to  the wall it will not move around
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here we have another image of intra-cystic  papillary carcinoma this one has a thick isoechoic septation as well these thick isoechoic septations  are usually a sign of malignancy as opposed to the
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thin hyperechoic septation which is usually  benign and here is a large thick mural nodule
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ductal carcinoma in situ will have hypoechoic  masses which will be micro lobulated which means they have these type of outpouchings and there  is no enhancement which means it is a solid mass
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in this image the mass involves  the ducts so it appears elongated
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usually these hypoechoic masses involving  the duct are ductal carcinoma in situ
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invasive ductal carcinoma is the most common form  of breast cancer it also has variable appearances
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one of them is a circumscribed mass
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hypoechoic mass with some calcifications  which are usually invasive ductal carcinoma
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here we have another case  of invasive ductal carcinoma
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we have an ill-defined hypoechoic mass and it has  a non-parallel orientation it is taller than wide
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the ap diameter will be more than the horizontal  measurement it also has posterior shadowing which is usually a sign of grade 1 invasive  ductal carcinoma but it is not always the case
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here we have invasive ductal carcinoma  with posterior acoustic enhancement
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this enhancement is usually a  sign of a higher grade cancer
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it also has a speculated appearance suggesting  a malignant lesion it is rated as bi-rads 4c
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here we have another image  of invasive ductal carcinoma
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showing us a circumscribed hyperechoic  mass with uniform internal echoes
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it also has posterior enhancement suggesting  a high grade cancer you can see that invasive ductal carcinoma has lots of appearances  ultimately it is confirmed with biopsy
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mastitis is the inflammation of breast tissue its  appearances consists of hyperechoic fat lobules
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and some hypoechoic areas another distinguishing  feature is that it has thickened skin here you can see the skin is very thick as compared to the  normal image these are the features of mastitis
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duct ectasia involves dilated duct with  branching tubular anechoic structures
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with the diameter measuring  more than two millimeters
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the normal ducts are somewhat difficult to  visualize they usually have mixed echoes
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here we have a case of infected and  inflamed cyst has thick isoechoic walls
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and it has dependent debris which means  this debris will settle down due to gravity
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this is the gravity dependent side this debris  will move in accordance with the patient position
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this debris will move using this feature we  can differentiate it from a neural nodule
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another feature is seen on doppler it is the  presence of increased blood flow in the thick wall
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a normal breast implant is anechoic  with a double layered hyperechoic shell
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and these are the normal breast tissues in  an implant rupture we have a step ladder sign
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which are linear horizontal hyperechoic  bands representing force of a collapsed shell
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it suggests intracapsular rupture
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a silicone granuloma suggests extra  capsular rupture and gives us a snowstorm sign in this we have a hyperechoic  circumscribed superficial border
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with dirty posterior shadowing  this shadowing is grayish
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thank you so much for watching please subscribe  and stay tuned for more imaging videos

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Perché praticare la conversazione con questo video?

Praticare la conversazione in inglese con questo video offre un'opportunità unica di imparare termini medici e tecnici utilizzati nell'ambito della diagnostica per immagini. L'uso di un linguaggio specifico, collegato a immagini di ecografie mammarie, permette agli studenti di familiarizzare con un contesto altamente specializzato. La ripetizione di espressioni e strutture grammaticali in questo contesto non solo migliora la competenza linguistica ma stimola anche la comprensione di argomenti complessi. Attraverso la pratica di conversazione in inglese, gli studenti possono anche sviluppare la loro capacità di utilizzare il linguaggio appropriato in situazioni professionali, migliorando la confidenza e la fluidità nella comunicazione.

Grammatica ed Espressioni nel Contesto

Nel video, il relatore utilizza diverse strutture grammaticali e termini chiave, tra cui:

  • Presentazione di informazioni: L'uso di frasi come "qui abbiamo le immagini" crea un senso di immediato coinvolgimento e aiuta nel costruire frasi descrittive.
  • Uso dei modali: Espressioni come "dobbiamo" o "si deve" possono essere trovate frequentemente per esprimere necessità o obbligo, elementi fondamentali nell'apprendimento di strutture di comando e suggerimenti.
  • Classificazione: La presentazione delle categorie BI-RADS utilizza frasi di classificazione che aiutano a strutturare le informazioni in modo chiaro e logico, essenziale per la comunicazione efficace.

Queste strutture possono essere ripetute durante la shadow speak per rafforzare la comprensione e la pronuncia di termini medici.

Trappole Comuni di Pronuncia

Nel video, il relatore pronuncia diversi termini tecnici potenzialmente complicati, come "hypoechoic", "echogenicity", e "fibroadenoma". Queste parole possono presentare delle sfide, in particolare la pronuncia delle sillabe e la corretta intonazione. È utile prestare attenzione a come il relatore enfatizza certe parti delle parole, poiché questo può influenzare la comprensione. Inoltre, l'accento su "bi-rads" e la sua classificazione richiedono una particolare attenzione per evitare confusione durante la comunicazione. Utilizzare una piattaforma di shadowing site con tecniche di shadowspeaks può aiutare gli studenti a superare queste difficoltà di pronuncia attraverso la pratica e la ripetizione, rendendo più facile padroneggiare questo linguaggio specialistico.

Cos'è la tecnica dello Shadowing?

Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.

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