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Objective To investigate the diagnostic value and characteristics of breast lesion in digital breast tomosynthesis (DBT) in combination with synthesized two-dimensional (2D) images. Methods The prospective study enrolled women older than 18 years with clinically suspected breast lesion.One hundred and sixty seven patients with 177 lesions confirmed by biopsy or surgery were included. All the patients underwent full-field digital mammography(FFDM)and DBT examinations,and synthesized 2D images(V-preview)were reconstructed from DBT.The images of FFDM,V-preview images and DBT plus FFDM, V-preview images were analyzed. The breast imaging reporting and data system (BI-RADS) and characteristic for predicting benign and malignant lesion were also evaluated.The average glandular dose for a single mammographic view between FFDM and DBT was recorded.The Nonparametric Z test was used to compare the differences among four different mammographic images in BI-RADS.The differential diagnostic performance among different mammography was evaluated by ROC analysis.Independent t test was used to compare the average glandular dose between FFDM and DBT.Results One hundred three benign lesions and 74 malignant lesions were confirmed. Compared with FFDM images alone or plus DBT,the diagnostic values of V-preview images alone/or plus DBT were not significantly different(Z=0.187 and 0.226,P=0.851 and 0.821), but compared with V-preview, the diagnostic values of V-preview images plus DBT revealed significant difference(Z=3.546,P<0.01).The area under ROC for V-preview plus DBT were 0.899,and the sensitivity,specificity,and accuracy were 90.5%,89.3%,and 89.3%,separately.For the average glandular dose, there was no significant difference between FFDM (1.48 ± 0.52) mGy and DBT (1.56 ± 0.39) mGy examination(t=1.714,P=0.087).Conclusion Synthesized 2D images from DBT,which may eliminate the need for FFDM,in combination with DBT can improve the diagnostic efficiency.
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Background and purpose: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for magnetic resonance imaging systemic examination, especially in examing the metastatic lesions, lymph node and bone diseases, and the imaging result is similar with PET. This study aimed to evaluate the application value of magnetic resonance DWIBS and positron emission tomography with computed tomography (PET/CT) on malignant metastatic diseases. Methods: Thirty-six patients confirmed with malignant tumors accompanying metastasis by the pathology of operation or biopsy underwent both DWIBS imaging and PET/CT, chi-square test and Kappa test were used for comparing the detection results of metastasis by these 2 imaging methods. Results:Among the 36 malignant tumor patients with 238 metastatic lesions, 218 (91.6%, 218/238) lesions in DWIBS and 209 (87.8%, 209/238) lesions in PET/CT were detected, with 200 lesions detected by the two methods simultaneously, and the concordance rate was 88.7%(211/238);but there was no statistical signiifcance between this two methods (χ2=1.843, P=0.157). Kappa test showed a fair concordance rate between DWIBS and PET/CT (P=0.000).There were different significance between DWIBS and PET/CT in detecting metastatic lesions of brain and bone (P=0.005 and 0.031);But there was no signiifcant differences (P=0.309 and 1.000) in detecting metastatic lesions of lymph nodes and liver. Conclusion:DWIBS could detect metastatic lesions effectively, and there is ifne consistency with PET/CT. DWIBS is more sensitive than PET/CT in detecting metastatic lesions of brain and bone, so DWIBS could be chosed for screening metastatic lesions according to the characteristics of different primary tumors.
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Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.
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Objective To describe the radiological features of mastitis.Methods Imaging findings were retrospectively reviewed in 58 women with mastitis,which was confirmed by pathological results.The imaging features were described according to the BI-RADS (breast imaging reporting and data system).All 58 patients had preoperative MRI,while 49 of them were examined with sonograms and 30 with mammograms preoperatively.Results Overall,no remarkable findings were reported on 6 mammography and 2 sonography examinations,but all 58 lesions were identified on MRI in our study.Asymmetrical density (n =16,53.3％) on mammograms and solitary or multiple separated/contiguous hypoechoic mass-like lesions (n =34,69.4％) on ultrasound were the most common signs of mastitis.On enhanced MR images,82.8 ％ (48/58) patients showed non-mass-like enhanced lesions.Multiple,regional enhancement (66.7％,32/48) and separated or contiguous,clumped,rim-like enhancement (63.1％,31/48) were the most common manifestations in non-mass-like enhanced lesions.Of the 58 patients,type Ⅰ and type Ⅱ timesignal intensity curve were detected in 48.3％ and 50.0％ of the patients,respectively.BI-RADS 0 had the highest frequency in reports on mammography (33.3％,10/30),while category 4a was most frequent on sonography (36.7％,18/49) and also on MRI (56.9％,33/58).Conclusion The imaging findings from mammography and US are non-specific for mastitis,therefore,MR can be helpful in the diagnosis,especially in the presence of non-mass-like enhancement that are multiple,regional,separated,or contiguous,clumped,and tim-like.
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ObjectiveTo evaluate the function of the salivary glands with gustatory stimulation by using MR DWI.MethodsA prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function.A DWI sequence was performed on the salivary glands at resting state,and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes (once every 18 seconds).The multiple b-values (0,400,600,800,1000 s/mm2) were used.ADC maps were evaluated with a manually placed region of interest including the entire salivary gland.The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland.The paired two-tailed Student t test was used to compare the ADC values of the parotid and the submandibular glands at rest,and of the parotid before and after stimulation.ResultsThe mean ADC value at rest was significantly lower in the parotid [ (1.23 ±0.12) × 10-3 mm2/s] than in the submandibular glands [(1.34 ± 0.07 ) × 10 -3 mm2/s,t =4.545,P ＜ 0.01 ].After acid stimulation,the ADC value increased from the baseline to (1.41 ±0.19) × 10-3 mm2/s firstly and then fluctuated at the following time,with a peak value of ( 1.49 ± 0.20 )× 10 -3 mm2/s and the average value of ( 1.36 ±0.17) × 10-3 mm2/s.The average value was significantly different from the baseline value (t =15.127,t =11.905,P ＜ 0.01 ).The minimum value [ ( 1.24 ± 0.14) × 10-3 mm2/s] was not significantly different compared to the baseline value (t =1.329,P ＞ 0.05 ).ConclusionMR DW1 can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation.
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ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3％ (4/28),53.6％ (15/28) and 32.1％ (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P ＜ 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4％ (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.
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Objective To investigate the value of magnetic resonance sialography (MRS) as a noninvasive tool in evaluating major salivary gland function before and after radiotherapy (RT) for nasopharyngeal carcinoma patients.Methods From August 2009 to June 2010,patients with stage Ⅰ and Ⅱa (AJCC/UICC 2002) nasopharyngeal carcinoma were enrolled.All the patients were treated with intensity modulated radiation therapy alone.MRS with salivary stimulation was performed in patients before and after RT on a 3.0T MR scanner.An MRS categorical scoring system was used to compare the visibility of ducts pre-RT and post-RT.The relationship between MRS score and EORTC Core QOL and EORTC Head and Neck QOL was analyzed.Spearman rank correlation test was performed to analyze the non-stimulated and stimulated MRS findings and the clinical severity of xerostomia.Results All 10 enrolled patients completed planned treatment.The mean dose of the parotid glands and submandibular glands were (37.99 + 3.70) Gy and (55.65 + 2.99) Gy,respectively.Good-quality MRS images were obtained.The visibility scores of both the parotid and submandibular ducts were increased after secretion stimulation.Irradiation decreased the visualization of the salivary ducts and attenuated the response to secretion stimulation.There were specific correlations between post-RT secretion response of the parotid gland and EORTC QLQ scales ( global QOL scale in QLQ-C30 ( rs =0.636,P =0.048 ) and xerostomia scale in QLQ H&N35 ( rs =- 0.694,P =0.026) ).Conclusions MRS can be used as a non-invasive way to evaluated of the functional changes of major salivary glands before and after RT and as a promising approach for investigating radiation-induced xerostomia.
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Objective To evaluate the diagnostic values of the breast imaging reporting and data system-MRI (BI-RADS-MRI)description about non-masslike enhancement by data mining. Methods Fifty-five patients with non-masslike enhancement lesions showed on breast contrast-enhanced MRI were evaluated using two data mining algorithms (Logistic regression and decision tree) and 10-fold cross-validation methods. Results There were 28 malignant and 27 benign lesions. The most frequent findings of the malignant lesions were clustered ring enhancement and clumped enhancement [ 12 and 4 lesions, respectively; 84. 2% (16/19) in decision trees, partial regression coefficients in Logistic model were 2. 128 and 1.723, respectively], whereas homogenous, stippled, reticular internal and linear ductal enhancement were the most frequent findings in benign lesions [ 4、9、1 and 7 lesions, respectively; 72. 4% (21/29) in decision tree, partial regression coefficients in Logistic model were 0.357 (homogenous), 1. 861 (stippled) and 18. 870( reticular), respectively]. 10-fold cross-validation indicated that decision tree (C5.0) achieved an accuracy of 69.3% with a sensitivity of 66.7% and a specificity of 71.7% in comparison to the Logistic regression model with an accuracy of 57. 0%, a sensitivity of 43.3% and a specificity of 71.7%. Conclusions The diagnosis efficacy of non-masslike enhancement interpretation according to BI-RADS-MRI is not high. It is very important to find more potential features of non-masslike enhancement to improve the diagnosis accuracy.
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dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.