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BACKGROUND: Although MRI is the most efficient method of detecting breast cancer, its standard protocol is time-consuming and expensive. The objective of this study was to compare the diagnostic accuracy of the modified innovative abbreviated MRI protocol (AMRP) and the standard magnetic resonance protocol (SMRP) when detecting breast cancer. METHODS: The research involved 477 patients referred for breast MRI due to suspected lesions. They were randomly assigned to the AMRP group (N = 232) or the SMRP group (N = 245). The AMRP comprised one native (contrast-free) and four post-contrast dynamic sequences of T1-weighted volume imaging for breast assessment (VIBRANT) and 3d MIP (maximum intensity projection) lasting for eight minutes. All the patients underwent a core biopsy of their lesions and histopathological analysis. RESULTS: The groups were comparable regarding the pre-screening and post-diagnostic characteristics and were of average (±SD) age at breast cancer diagnosis of 53.6 ± 12.7 years. There was no significant difference between the two protocols in terms of specificity or sensitivity of breast cancer diagnosis. The sensitivity (95% Cis) of the AMRP was 99.05% (96.6-99.9%), and its specificity was 59.09% (36.4-79.3%), whereas the sensitivity of the SMRP was 98.12% (95.3-99.5%) and its specificity was 68.75% (50.0-83.9%). Most of the tumors comprised one solid lesion in one of the breasts (77.3%), followed by multicentric tumors (16%), bilateral tumors (4.3%), and multifocal tumors (1.7%). The average size of tumors was approximately 14 mm (ranging from 3 mm to 72 mm). CONCLUSION: Our innovative AMR protocol showed comparable specificity and sensitivity for the diagnosis of breast cancer when compared to SMRP, which is the "gold standard" for histopathological diagnosis. This can lead to great savings in terms of the time and cost of imaging and interpretation.
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PURPOSE: Pulmonary arteriovenous malformations (PAVM) are the direct communications between the pulmonary arteries and veins. These malformations can cause serious complications, and most of these patients should be treated. Herein we present our experience in the treatment of 18 cases of PAVM, treated with endovascular embolisation. MATERIAL AND METHODS: Eighteen patients with PAVMs underwent endovascular embolisation during a five-year period. Eight were male and 10 were female, with ages ranging from 16 to 65 years. Standard steel coils and vascular plug were used for embolisation. RESULTS: Embolisation was successful in 17 of 18 patients. Coiling was used in 10 patients, vascular plug in five, and both materials in two patients. All symptomatic patients with successful embolisation lost all their symptoms after treatment. Control angiography after embolisation showed a closure of AV shunt without migration of embolic material in all patients. Post-embolisation syndrome developed in four patients and late onset of pleural pain in three patients. There was no connection between pleural reaction and type of PAVM and embolic material. CONCLUSIONS: Endovascular PAVM treatment is a minimally invasive, highly successful method with a low rate of only transitory complications.
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BACKGROUND: To retrospectively analyze the outcomes of interventional radiology treatment of patients with hepatic artery stenosis (HAS) after liver transplantation at our Institution. MATERIAL/METHODS: Hepatic artery stenosis was diagnosed and treated by endovascular technique in 8 (2.8%) patients, who underwent liver transplantation between July 2007 and July 2011. Patients entered the follow-up period, during which we analyzed hepatic artery patency with Doppler ultrasound at 1, 3, 6, and 12 months after percutaneous endovascular treatment (PTA), and every six months thereafter. RESULTS: During the 12-month follow-up period, 6 out of 8 patients (75%) were asymptomatic with patent hepatic artery, which was confirmed by multislice computed tomography (MSCT) angiography, or color Doppler (CD) ultrasound. One patient had a fatal outcome of unknown cause, and one patient underwent orthotopic liver retransplantation (re-OLT) procedure due to graft failure. CONCLUSIONS: Our results suggest that HAS angioplasty and stenting are minimally invasive and safe endovascular procedures that represent a good alternative to open surgery, with good 12-month follow-up patency results comparable to surgery.