Objective To assess the clinical efficacy of neoadjuvant chemotherapy （NAC） for breast invasive ductal carcinoma with MR diffusion weighted imaging. Methods Thirty patients with breast invasive ductal carcinoma underwent conventional MRI scanning and diffusion weighted imaging examination before and after preoperative neoadj-uvant chemotherapy. Two experienced radiologists independently analyzed and measured the maximum lesion diameter and apparent diffusion coefficient （ADC） values before and after treatment，respectively. Statistical analysis was performed for testing the tumor maximum diameter and ADC values change by using the paired t-test. Results After NAC treatment，the maximum tumor diameter of invasive ductal breast carcinoma sharply reduced〔（4.33±0.83） cm vs. （2.04±0.64） cm，P＜0.001〕. When b value was 1 000，the mean ADC values of breast massess were significantly changed after NAC treatment〔（1.89±0.15） ×10-3mm2/s vs. （1.14±0.31） ×10-3mm2/s， P＜0.05〕. Conclusion MR diffusion weighted imaging can non-invasively and accurately assess the NAC efficacy， which are helpful for making surgical strategies.
Objective To assess the radiation dose and image quality with low-dose multi-detector row CT urography （CTU） for the evaluation of children patients with ureteropelvic junction stenosis （UJS）. Methods In this prospective study， 30 children patients with UJS underwent CTU were classified half-randomly through exam numbers into 3 groups （115 mA， 100 mA， and 75 mA）. Consecutive acquisitions including CT dose index weighted （CTDIw） and dose long product （DLP） were obtained in each patient and compared for each group. Three experienced chest radio-logists were unaware of the CT technique reviewed CT images for overall image quality using a 3-grade scale （excellent， good， and worst）. The data were analyzed using a parametric analysis of variance test and Wilcoxon’s signed rank test. Results The CTDIws of 115 mA group， 100 mA group， and 75 mA group were （7.63±0.83） mGy， （6.29±0.51） mGy， and （4.72±0.18） mGy， respectively， the difference was significant among three groups （F=36.445， P=0.000）. The mean CTDIw reduction was 38.2% in the 75 mA group as compared with 115 mA group （P＜0.001）. The DLPs of 115 mA group， 100 mA group， and 75 mA group were （173.89±29.88） mGy•cm， （145.96±26.21） mGy•cm， and （102.78±12.72） mGy•cm， respectively， the difference was significant among three groups （F=13.955， P=0.000）. The mean radiation dose reduction was 40.9% （75 mA group versus 115 mA group， P＜0.001）. The assessment of image quality was no significant difference with the same protocol and post-processing technique （Wilcoxon’s signed rank test， P＞0.05）. There was a good agreement for image quality scoring among the three reviewers （Kappa=0.736）. Conclusion Low-dose multi-detector row CTU should be considered as a promising technique for the evaluation of children patients with UJS because it could decrease radiation dose and obtain acceptable image quality.
Objective To investigate the CT and pathological findings of adrenal myelolipoma， so as to improve the accuracy of diagnosis. Methods CT manifestations of twelve cases with pathological documented adrenal myeloli-pomas were retrospectively analyzed. Combined with pathological features， the location， size， shape， density， and surro-unding structures of adrenal myelolipomas were evaluated on CT image， respectively. Results Of 12 cases with adrenal myelolipomas， 9 cases arose from right adrenals， 2 cases from the left，and 1 case involved bilateral adrenal glands. CT features delineated the mixed density masses arising from adrenals， but majority components were fat densities. Pathological examination demonstrated the tumor was composed of mature fat cells and bone marrow cells. Compared with pathologic results， preoperative CT diagnosis was reliable for significant accuracy （11/12）. Conclusions Adrenal myelolipoma is rare. Combined with pathological characteristics clinical findings and laboratory tests， adrenal myelolipoma can be corr-ectly diagnosed with CT examination.
Objective To investigate the value of MRI on the preoperative diagnosis for breast invasive ductal carcinoma combined with histopathology. Methods Seventy-five patients with breast invasive ductal carcinoma confirmed with surgery and pathology were reviewed， which were treated in our hospital from Jan to Jun in 2012. The data of MRI before operation were retrospectively analyzed. Results The morphological classification of lesions was mass in 54 cases， micronodular in 21 cases， and cystoid solid in 0 case， respectively. The shape of neoplasm was circular in 3 cases， ovoid in 9 cases， and irregular in 63 cases， respectively. The edge of lesions was irregular in 66 cases，regular in 9 cases， and slightest lobulated in 56 cases， respectively. There was 1 case within the tumor calcification and lymph node metastasis in 18 cases. The MRI features of the T1WI were low signal intensity in 65 cases， signal intensity similar in 10 cases， and the T2WI were low signal intensity in 3 cases and mixed slightly high signals in 72 cases. After enhancement， the tumor had homogeneous enhancement in 64 cases， heterogeneous enhancement in 11 cases. Conclusion The analysis of MRI characteristic features of invasive ductal carcinoma can provid b evidence of imaging for clinical diagnosis of breast invasive ductal carcinoma.
This paper aims to investigate the value of diffusiion weighted imaging (DWI) and different apparent diffusion coefficient (ADC) methods to predict the curative effects of neoadjuvant chempotherapy (NAC) for breast cancer. From March 2010 to December 2012, seventy-one patients were pathologically confirmed invasive breast cancer by needle puncture biopsy received before surgery, and underwent magnetic resonance before and after NAC, the ADC were measured by mean ADC method and lower ADC method. The pathologic response after NAC was divided to major histological response (MHR) group and non-major histological response (NMHR) group according to Miller & Payne system. Results displayed that ADC values obtained before NAC, at the end of the second cycle of NAC, and after whole course of treatment, had good correlations between mean and lower ADC methods (the Pearson's correlation=0.699, 0.749 and 0.895, respectively). Significant difference in ADC obtained both with mean and lower ADC methods could be found between MHR and NMHR groups after the second cycle of NAC (P<0.05). After the second cycle of NAC, significant difference in the change rate of ADC could be found between MHR and NMHR groups by using lower ADC method (P<0.05), but not be found by using mean ADC method (P＞0.05). In conclusion, DWI could monitor the pathologic changes of breast cancer after NAC, and the lower ADC method might be used to evaluate the curative effect of NAC with the change rate of ADC.
Objective To investigate the mammographic appearance of breast phyllodes tumors and the relation- ship of mammographic appearance to clinicopathologic features， and to determine the differential characteristics and pathologic basis. Methods The clinical and imaging findings of 28 patients with surgically confirmed phyllodes tumorsfrom January 2010 to January 2013 were analyzed retrospectively. The radiological features were compared with path-ology. Results Seventeen benign， 8 intermediate， and 3 malignant phyllodes tumors were identified by the histopatho-logic review. Mammography demonstrated the tumors as a mass lesion in 26 cases and asymmetric opacity in 2 cases. The tumors were 2.8-10.2cm in diameter. The difference of rate of intermediate and malignant phyllodes tumors and benign phyllodes tumors was not statistically significant between ≥3cm and ＜3cm in diameter （Ρ＞0.05）. Although all the tumors showed lobulated margins except for 4 cases in the benign phyllodes tumors， it was not a significant finding（Ρ＞0.05）. However， poorly defined borders in the malignant and intermediate phyllodes tumors were more frequent than those in the benign phyllodes tumors （Ρ＜0.05）. Abnormal blood vessels were seen in 2 cases of benign phyllodes tumors and calcification was seen in 1 case of benign phyllodes tumors， while 10 tumors were surrounded by a clear halo， of them 8 were the benign phyllodes tumors and 2 were the intermediate and malignant phyllodes tumors （Ρ＞0.05）. Conclusions Mammographic features combined with clinical behavior can be helpful for early detection， but definite diagnosis and classification should be verified by histopathologic examination.
Objective To detect the features of breast carcinoma with nipple discharge using selective galactography and evaluate the value of this method. Methods The galactography findings of 39 cases of pathology proved breast carcinoma with nipple discharge were analyzed retrospectively. Results Among the 39 cases, the pathology diagnosis included 7 cases of intraductal papillary carcinoma, 13 cases of ductal carcinoma in situ, and 19 cases of invasive ductal carcinoma. The galactographic features included: duct filling defect (24 cases, 61.5%), ductal obstruction (15 cases, 38.5%), rigidity and disorder (31 cases, 79.5%), wormy erosion sign (18 cases, 46.2%), pond lake sign (4 cases, 10.3%), ductal interruption (17 cases, 43.6%), ductal stenosis (24 casesm, 61.5%), ductal dilatation (22 cases, 56.4%). Among all of the cases, the accuracy rate of mammography and galactography was 64.1% (25/39) and 87.2% (34/39), respectively (P＜0.05). Among the 13 cases of ductal carcinoma in situ, the accuracy rate of mammography and galactography was 61.5% (8/13) and 100% (13/13), respectively (P＜0.05). Conclusion Selective galactography could improve the detection rate of breast carcinoma, and has great value in the early diagnosis of ductal carcinoma in situ.
ObjectiveTo compare Crohn disease(CD) with intestinal tuberculosis(ITB) in clinical and multislice CT(MSCT) features that may be helpful for the differential diagnosis. MethodsThirty-eight patients with CD and 13 with ITB proved surgically and pathologically were recruited for this study. The clinical symptoms, laboratory, and MSCT findings in these patients were retrospectively analyzed. ResultsThe MSCT changes helpful in distinguishing CD from ITB included:①CD presented symmetrical intestinal wall thickening in most cases, while ITB were asymmetric (P < 0.05).②The irregular stricture was more common usually shown in CD groups, while coaxial in ITB(P < 0.05).③The lymphadenopathy with obvious enhancement and tortuously mesenteric vessels were frequently found in ITB group (P < 0.05). The clinical features of CD including abdominal pain, diarrhea, fever, anemia, hematochezia, weight loss, and intestinal complications were similar with ITB, and similar results were detected in the laboratory examination including the acceleration of erythrocyte sedimentation rate, postive C-reactive protein, and the reduction of albumin. The feature of hematochezia was more common in CD than in ITB, while concomitant pulmonary tuberculosis was more revealed in ITB(P < 0.05). ConclusionsThe MSCT findings of CD and ITB are characteristic. Combined with the similar clinical and laboratory features, the features of MSCT maybe helpful for definitive diagnosis.
ObjectiveTo help junior radiologists and surgeons better interpret MRI images of rectal cancer.MethodThe guidelines, expert consensus and research progress on the application of MR imaging in rectal cancer in recent years were reviewed.ResultsRectal MR had the ability to accurately evaluate a number of important findings that may impact patient’ management, including distance of the tumor to the mesorectal fascia, presence of extramural vascular invasion, and presence of lymph nodes.ConclusionsRectal MRI is an important basis for clinical staging and multidisciplinary diagnosis and treatment of rectal cancer. Surgeons and radiologists must master the key imaging anatomical basis and clinical practice points in order to accurately interpret the image information of MRI in rectal cancer.