ABSTRACT
Objective To explore the application value of different dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) models in pathological grading of breast invasive ductal carcinoma.Methods Forty-five cases of breast invasive ductal carcinoma confirmed by clinical pathology from June 2016 to October 2017 in Shanxi Provincial People's Hospital were enrolled in this study.Grade 1 and 2 invasive ductal carcinomas were classified into the low-grade group,grade 3 invasive ductal carcinomas was classified as the high-grade group.The whole patients underwent DCE-MRI scans.Volume transport constant (Ktrans) was obtained by using the Extended Tofts Linear model with population arterial input function (AIF).Then,the Reference Region model was used to obtain the reference region model volume transport constant(RRKtrans).The performances of histogram analysis of these two quantitative parameters in pathological grading of breast invasive ductal carcinoma were compared.Results The mean,25 ％,50 ％,75 ％,90 ％ percentiles,kurtosis and skewness of RRKtrans in high grade group were (0.793±0.258)/min,(0.484±0.209)/min,(0.773±0.277)/min,(1.066±0.351)/min,(1.322±0.406)/min,2.647 (1.426,3.679),0.398 (0.297,0.514) respectively,and the corresponding parameters in low grade group were (0.506±0.203)/min,(0.301 ±0.142)/min,(0.487 ±0.211)/min,(0.692±0.281)/min,(0.861±0.323)/min,1.725 (0.779,2.316),0.258 (0.133,0.302) respectively.There were significant differences between the two groups (all P ＜ 0.05).The mean,50 ％,75 ％,90 ％percentiles of Ktrans in high grade groups were (0.099±0.034)/min,(0.110±0.033)/min,(0.132±0.045)/min,(0.140±0.047)/min respectively,and the corresponding parameters in low grade group were (0.067±0.030)/min,(0.082 ±0.067)/min,(0.096 ±0.059)/min,(0.113 ±0.074)/min respectively.There were significant differences between the two groups (all P ＜ 0.05).RRKtrans was superior to Ktrans in distinguishing area under the curve (AUC) of receiver operating characteristic curve (ROC) of high and low grading of breast invasive ductal carcinoma.Conclusion RRKtrans obtained by Reference Region model and Ktrans obtained by Population AIF DCE-MRI have some values in pathological grading of breast invasive ductal carcinoma,but the performance of RRKtrans is superior to Kftrans.
ABSTRACT
Objective To investigate the clinical manifestations and possible reasons of the missed and inaccurate diagnosis of Fuchs syndrome. Methods The clinical data of 85 patients with Fuchs syndrome who were diagnosed and treated from June 1999 to December 2003 were retrospectively analyzed. The disease history of each patient was carefully recorded. Slit-lamp microscopy was performed on the patients. The character and distribution of keratic precipitates (KP), color of the iris, depigmentation, and complications were noted in detail. The data recorded in other hospitals were analyzed and the reasons of missed and inaccurate diagnosis were statistically analyzed. Results The age of the patients ranged from 13 to 72 years, and binocular involvement was noted in 76 patients. None of the patients showed ciliary congestion and iris synechiae. Middle-sized or stellated KP was found. Triangle-distributed KP was seen in 13 patients, and diffuse distribution behind the corneal or in the pupil area was in 72. Anterior-chamber flare was observed in all of the patients, while anterior-chamber cells were only noted in 42 patients. The iris with different degrees of depigmentation was found in all the patients. Complicated cataract and increased intraocular pressure occured in 44 and 19 patients, respectively. The diagnosis in other hospitals mainly included uveitis, anterior uveitis and complicated cataract. Conclusions Fuchs syndrome is characterized by depigmented iris and typical KP. Missed and inaccurate diagnosis is mainly due to the unawareness of its clinical features.