ObjectiveTo summarize the basic principles, techniques, and clinical applications of contrast-enhanced spectral mammography (CESM).MethodsThe literatures about CESM in recent years were collected to make an review.ResultsCESM had a low energy image and subtracted image, could provide both morphology information and enhancement characteristics of breast lesions. CESM had been adopted in some clinical applications, such as problem solving of inconclusive findings, preoperative evaluation of tumor extent, and assessing residual malignancy after neoadjuvant systemic therapy.ConclusionCESM has equal clinical value with MRI, but it needs short examination time, and lead to easy accessibility and fewer cost, which might be a suitable alternative in the department that do not have MRI.
ObjectiveTo investigate the relationship of dynamic contrast enhanced(DCE) MRI scan of the mass type of invasive ductal breast cancer to histological grade.
MethodThe imagings of DCEMRI of 92 patients confirmed with operation or biopsy pathology and its correlation with WHO histological grade were analyzed.
ResultsThere were 29(31.52%) patients with the tumor long diameter≤2 cm, 53(57.61%) 2-5 cm, 10(10.87%)≥5 cm. There were 3(3.26%) patients with round of the morphological lesions, 7(7.61%) oval, 33(35.87%) lobulated shape, 49(53.26%) irregular shape. There were 11 (11.96%) patients with smooth margin of the periphery of the lesions, 47 (51.09%) irregular shape, 34(36.96%) spiculate margin. There were 15(16.30%) patients with homogeneous enhancement, 40(43.48%) heterogeneous enhancement, 37(40.22%) ring-like enhancement. WHO pathological grade:grade 1 was in 5 cases(5.43%), grade 2 in 30 cases(32.61%), grade 3 in 57 cases(61.96%). The statistical results showed that MRI dynamic enhancement characteristics of lesions in size, shape, and enhanced features were correlated with WHO pathological grade (P < 0.05), there was no correlation between the edge features of the tumor and WHO histological grade(P > 0.05).
ConclusionThere is a certain correlation between the breast cancer enhanced MRI features and WHO histological grade, which can be evaluated biological behavior and prognosis according to MRI signs of lesions.
ObjectiveTo investigate the chest radiographic and computed tomographic manifestations of allergic bronchopulmonary aspergillosis (ABPA).
MethodWe retrospectively analyzed the chest radiographic and computed tomographic manifestations of 20 ABPA patients treated between December 2005 and December 2013.
ResultsChest radiograph showed that there were 4 negative cases, 14 cases of solid mass, 10 cases of increased and disorder of bronchovascular shadows, and 5 cases of bronchiectasis. Chest computed tomography showed that there were one negative case, 18 cases of bronchiectasis, 17 cases of central bronchiectasis among which central and peripheral bronchi were involved in 6 cases and 1 case presented as pure peripheral bronchiectasis, 11 cases of tree-in-bud signs, 6 cases of mucous embolism, 8 cases of solid mass, 5 cases of ground-glass opacity, 4 cases of pleural thickening, 3 cases of pleural effusion, and 2 cases of atelectasis.
ConclusionsFor asthma and cystic fibrosis patients, central bronchiectasis on chest CT indicates the diagnosis of ABPA, but it cannot be considered as a characteristic feature. Bronchiectasis combined with high attenuation mucus may be a characteristic feature of ABPA although it is rare.
Objective To explore a new rotation training mode suitable for residency standardized non-professional radiological trainees in radiology department, so as to improve the training quality. Methods The residency standardized non-professional radiological trainees who rotated in the Department of Radiology, West China Hospital, Sichuan University between June 2021 and January 2022 were retrospectively included as the research objects. According to the training mode, they were divided into traditional training mode group and innovative training mode group. The training results of the two groups were compared by taking process assessment, final examination and final score as evaluation indicators. Results Finally, 122 residents were included, including 45 in the traditional training model group and 77 in the innovative training model group. There was no significant difference in gender, major, identity and grade between the two groups (P>0.05). There was no significant difference between the two groups in the first film reading skill examination and their usual homework performance (P>0.05). The score of the second film reading skill examination [15 (14, 16) vs. 12 (11, 13)], the score of the final examination [34 (31, 36) vs. 29 (25, 31)] and the final score [80 (76, 83) vs. 71 (67, 74)] in the innovative training mode group were better than those in the traditional training mode group (P<0.05). Conclusion The innovative training mode of online teaching platform combined with offline teaching can improve the training effect of residency standardized non-professional radiological trainees in radiology department.
ObjectiveTo assess the values of MRI, ultrasound (US), and X-ray in the differential diagnosis of benign and malignant breast lesions.
MethodsThe image data of 50 breast lesions confirmed with histopathology were analyzed retrospectively and the values of MRI, US and X-ray mammography in the differential diagnosis of benign and malignant breast lesions based on the breast imaging reporting and data system (BI-RADS) were assessed. The diagnostic efficiency of MRI, US, and X-ray in 50 benign and malignant breast lesions were compared using receiver operating characteristics (ROC) curves. The areas of ROC curves of MRI, US, and X-ray were calculated with Z test using SPSS 16.0.
ResultsThere were 44 patients with 50 breast lesions, 26 malignant lesions, 24 benign lesions. Based on the BI-RADS, according to X-ray imaging features, 26 malignant breast lesions were classified as 5 lesions of category 5, 7 lesions of category 4, 6 lesions of category 3, 3 lesions of category 2, 1 lesion of category 1, 4 lesions of category zero. Twenty-four benign breast lesions were classified as 1 lesion of category 4, 3 lesions of category 3, 4 lesions of category 2, 13 lesions of category 1, 3 lesions of category zero. According to the characteristics of US findings, 26 malignant breast lesions were classified as 17 lesions of category 5, 4 lesions of category 4, 1 lesion of category 3, 1 lesion of category 2, 3 lesions of category 1. Twenty-four benign breast lesions were classified as 1 lesion of category 5, 2 lesions of category 4, 4 lesions of category 3, 14 lesions of category 2, 2 lesions of category 1, 1 lesion of category 0. According to MRI imaging findings, 26 malignant breast lesions were classified as 6 lesions of category 5, 18 lesions of category 4, 1 lesion of category 3, 1 lesion of category 1. Twenty-four benign breast lesions were classified as 20 lesions of category 1, 3 lesions of category 2, 1 lesion of category 3. The area under the ROC curve of the MRI, US, and X-ray was 0.977, 0.835, and 0.764, respectively. The differences of MRI with US (Z=2.05, P < 0.05) and MRI with X-ray mammography (Z=2.81, P < 0.05) were statistically significant. While the difference of US with X-ray mammography (Z=0.73, P > 0.05) was't statistically significant.
ConclusionsDynamic contrast-enhanced MRI is an accurate examination in the differential diagnosis of benign and malignant breast lesions. The differential diagnostic efficiency of MRI is significantly better than those with US and X-ray.
Right-sided cardiac valvular diseases have traditionally been considered less important than disease of mitral or aortic valve. However, severe tricuspid regurgitation could lead to right ventricle dysfunction and reduce patients' survival rate. In clinic setting, tricuspid valve disease should be paid more attention for patients with secondary tricuspid regurgitation caused by left-sided valvular surgery combined with irreversible annular dilatation increasing the risk of re-operation. In this review, we summarize the epidemiology, anatomy, pathology, diagnosis, ultrasound and cardiac magnetic resonance imaging findings in patients with tricuspid regurgitation.
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.
This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
