ABSTRACT
Objective To compare the value of diffusion kurtosis imaging (DKI) model with single-index DWI model parameters in the differential diagnosis of benign and malignant breast lesions,and to explore the correlation between the parameters and molecular subtypes and prognostic factors of breast cancer.Methods A retrospective analysis was performed with inclusion of 64 cases of breast diseases from January 2016 to May 2017 in Shanghai First People's Hospital.The patients were pathologically confirmed and typed, 30 cases are malignant tumors and 34 cases are benign lesions. DKI and DWI were performed within 2 weeks before the pathological examination. Invasive ductal carcinoma of grade Ⅰ, Ⅱ and Ⅲ were revealed in 1, 7 and 13 cases respectively. Luminal A breast cancer was found in 10 cases, Luminal B breast cancer was diagnosed in 11 cases, HER-2 positive breast cancer was 4 cases and triple negative breast cancer was 5 cases. The expressions of estrogen receptor (ER), Progesterone receptor (PR), and HER-2 positive were found in 20, 14 and 15 cases respectively. Ki67 was highly expressed in 24 cases and low expression in 6 cases. All patients underwent both plain and enhanced mammography scanning. The kurtosis (MK), mean diffusivity (MD) and ADC value were measured. Prognosis analysis was performed according to the maximum diameter (>2 cm, ≤2 cm), vascular or neurological invasion (positive, negative), lymph node metastasis (positive, negative), ER (positive, negative), PR (positive, negative), HER-2 (positive, negative),Ki67 (positive, negative), pathological grade (grade Ⅰ+Ⅱ,Ⅲ). Two independent samples t test was used to compare DKI and DWI parameters between benign and malignant lesions. ROC analysis was performed for assessing the values of parameters in discriminating benign and malignant breast lesions. Mann-Whitney U and Kruskal-Wallis H tests were used for the comparison of various prognostic factors or molecular subtypes.Spearman rank correlation analysis was used to explore the correlation of different prognostic factors and DKI and DWI parameters. Results The MK value of malignant group was higher than that of benign group,and the MD value and ADC value were lower than that of benign group (P<0.05). The area under the ROC for MK, MD and ADC were 0.897, 0.827 and 0.776, respectively. The area under the ROC was improved to 0.935 when three parameters were combined. The MK of ER positive group was higher than that of negative group (P<0.05). There was no significant difference of parameters among the other prognostic groups (all P>0.05). There was a low positive correlation between ER and MK (r= 0.417, P= 0.022). There was no correlation between the other prognostic factors and parameters (r=－0.086 to 0.313, all P>0.05). There was no significant difference in the MD, MK and ADC values among the four different subtypes of breast cancer (all P>0.05). Conclusions MK, MD and ADC values can be used to discriminate benign and malignant breast tumors, among which MK value has the best diagnostic performance. There is a certain correlation between DKI model parameters and prognostic factors.
ABSTRACT
Objective To explore the MSCT findings of occipital condyle fracture (OCF) and improve its diagnostic accuracy. Methods Nineteen patients with OCF, selected from 110 patients suffering high energy injuries at the craniocervical junction, were enrolled into the study. The MSCT appearances of OCFs were retrospectively analyzed by two experienced radiologists. OCF had four types: type Ⅰ was a comminuted fracture, type Ⅱ was a extension of basilar skull fracture, type Ⅲ was an avulsion fracture at the attachment site of alar ligament on occipital condyle, type Ⅳ was a fracture of mixed pattern consisting of two or more above fracture types. Results In 19 patients, the left, right and bilateral OCFs were seen in 7,11 cases, and 1 case, respectively. Type Ⅰ was found in one case, which was a comminution of the left occipital condyle. Type Ⅱ was found in 5 cases, which involved the middle and posterior parts of occipital condyles with 2 on the left and 3 on the right, Type Ⅲ was found in 12 cases which showed various degree of fragment displacement with 3 occuring on the left, 8 on the right, 1 involving bilateral sides, 6 involving articular surfaces and 7 accompaning by enlargment of alar ligaments. Type Ⅳ was found in one case, with coexistence of Type Ⅱ and type Ⅲ. In addition, OCFs were accompanied by head and (or) cervical spine injuries in 14 cases, which included cranial fracture in 8 cases, epidural hematoma in 4 cases, subarachnoid hemorrhage in one case, cerebral contusion and laceration in one case, subfalcial hernia in one case, cervical spine fracture and dislocation in 9 cases, and so on. Conclusion OCFs can be accurately diagnosed by MSCT, which is important for selection of treatment protocols.
ABSTRACT
Objective To investigate the effects of labeling Schwann cells with different concentrations of SPIO, and to investigate the feasibility of in vitro MR imaging. Methods The C57BL/6 mices'Schwann cells were isolated, purified, and then 0.5 × 106, 1.0 × 106, 5.0 × 106 cells were labeled with 25.0 μg/ml, 50.0 μg/ml SPIO. Prussian blue stain and transmission electron microscope (TEM) were performed for showing intracellular iron. The signal intensity of cells were evaluated by 3.0 MRI with different sequences in vitro. Results Different cell population (0.5 × 106, 1.0 × 106,5.0 × 106) were cultured with different concentration SPIO about 24 hours. Dyeing degree of labeling cells stained by Prussion blue gradually deepened from 25.0 μg/ml to 50.0 μg/ml. Transmission electron microscope indicated that iron particles accumulated inendosomes/lysosomes. The MR signal intensity of labeling cells were inversely correlated with the concentration of SPIO groups in T2WI and GRE/30° imaging in vitro. Conclusion Schwann cells could be labeled effectively with SPIO, and MRI could be used to monitor these labeled cells in vitro.
ABSTRACT
Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.
ABSTRACT
Objective To introduce the procedures and to evaluate the application value of the optical navigating interventional MR-guided percutaneous biopsies and therapies. Methods Thirty-five of 54 patients (33 males, 21 females) underwent percutaneous biopsies and 19 of 54 patients underwent percutaneous therapies under optical navigating interventional MR-guidance. The age ranged from 9 months to 78 years (mean 38.8 years). All patients were performed under a 0.23 T open MRI system (Proview, Philips Medical System) with optical navigating system (iPath 200, Philips Medical System). The needle and bone biopsy drill were MR-compatible (Daum, Germany). Results Punctures were accurate in all patients (54/54). 33 of 35 biopsies got the pathological diagnosis. All therapies (19/19) got the definitive curative effect. All patients had no obvious complications, such as severe hemorrhage, viscera or nerve injury.Conclusion iPath 200 interventional MR-guided percutaneous biopsies and therapies are accurate and safe techniques.