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.
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 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.
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.
目的:评价先天性心脏病（CHD）不同病变类型在64层螺旋CT（64-MDCT）三维重建图像上的表现及显示效果。方法:回顾性分析36例CHD患者的64-MDCT资料,分别在轴位、冠状、矢状位及容积再现（VR）重组图像上观察病变,统计分析不同重组图像显示总体病变及房、室间隔缺损效果有无差异。结果:36例患者共有病变59处,轴位、冠状及矢状位图像在发现病变（59处,100.0%；57处,96.6%；53处,89.8%）及室间隔缺损显示（显示效果评分:41、38及39分）方面无明显差异（P＞0.05）,但轴位图像显示房间隔缺损明显优于冠、矢状位图像（显示效果评分:19、13及12分）（P＜0.05）。VR图像与轴位及冠、矢状位图像显示心外大血管病变效果无差异P＞0.05）。不同类型病变在轴位,冠、矢状位及VR图像上表现特征不尽相同,而不同重组图像有各自优势显示的病变类型。结论:64-DCT三维重建图像能够很好地显示先心病各种类型病变,了解不同重建图像上病变表现特征及显示效果有利于做出准确、全面的诊断。
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.
ObjectiveTo explore the differences and similarities of the featurs of lymph node metatasis of abdominal esophageal carcinoma and cardiac cancer. MethodsPreoperative CT images of abdominal esophageal carcinomas and cardiac cancers were reviewed and analysed on lymph node size and preponderant distribution. ResultsShort diameter ≥10 mm of lymph node at CT was adopted as metastasis criterion. The detection rates of abdominal esophageal carcinomas and cardiac cancers were 73.5%（144/196） and 83.7% （170/203）, respectively. Thoracic lymph node metastasis rate of abdominal esophageal carcinomas was 11.1% （4/36） in 7 area, 27.8% （10/36） in 8 area, 8.3% （3/36） in 9 area, while celiac lymph node metastasis rate was 36.1% (13/36 ） in No.7 group, 19.4% （7/36） in No.1 group, and 11.1% （4/36） in No.2 group primarily. Lymph node metastasis rate of cardiac cancers was 17.9% （5/28） in No.1 group, 28.6% （8/28） in No.2 group, 39.3% （11/28 ） in No.3 group, and 25.0% （7/28） in No.4 group for the first stop lymph nodes, and 35.7% （10/28 ） in No.7 group for the second stop primarily. ConclusionAs metastasis criterion, short diameter ≥10 mm of lymph node at CT is feasible, but there exist certain falsepositive rate. Thoracic lymph node metastasis of abdominal esophageal carcinomas is mainly in the 7, 8, and 9 area, while celiac metastasis is mainly in No.7, No.1, and No.2 groups. Lymph node metastasis of cardiac cancers is in No.1, No.2, No.3, No.4, and No.7 group primarily.
ObjectiveTo investigate the X-ray diagnostic significance of calcification of the breast tumor without mass. MethodsMammograms of 90 cases of breast tumor without mass confirmed pathologically were retrospectively analyzed. There were 55 cases confirmed benign breast tumor, and the rest cases were breast cancer. The shape, distribution, total number, location of calcifications in the breast, and asymmetric dense of the breast were recorded and watched. Results①The X-ray findings of calcification in benign breast tumors always presented as coarse granular (31), scattered shape (35) with small number, less with the asymmetric dense of the breast (7), and the change of side with axillary lymph node (2). ②Meanwhile, fine sand-like (32), showing the cluster-like distribution (24) with larger number, with the asymmetric dense of the breast (24) and the change of side with axillary lymph node (10). Both of the differences of the calcifications (the shape, the distribution, and the total number) were statistically significant (Plt;0.05). ConclusionsThe calcifications of benign and malignant breast tumors have their unique X-ray characteristics. And there is a great value in differentiating early benign and malignant breast tumor.