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.
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.
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.
ObjectiveTo summarize the application of spectral CT in the diagnosis of common, frequently occurring, and acute severe gastrointestinal diseases. MethodThe literature and guidelines on spectral CT were reviewed, and the main conclusions and opinions were summarized. ResultsThe spectral CT could obtain a variety of tissue parameters through a single scan. Through post-processing, multiple sequence images could be obtained, including virtual single-level images, virtual unenhanced images, iodine density images, effective atomic number images, etc. And multiple quantitative indicators could also be obtained, including iodine concentration, standardized iodine concentration, spectral curve, effective atomic number, etc. It could improve the signal-to-noise ratio of the image, reduce artifacts, increase iodine contrast, and decrease iodine load, then could improve the detection rate of active gastrointestinal bleeding and ischemic bowel diseases, improve the assessment accuracy of inflammatory activity of Crohn disease, and help to identify benign and malignant gastrointestinal tumors, determine the histological origin and evaluate the therapeutic effect. ConclusionFrom the conclusion summarized in this review, spectral CT images and quantitative indicators could provide more valuable information for detection, diagnosis, and prognosis of gastrointestinal diseases.