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Objective To investigate the characteristics of multimodal MRI of breast cancer with different molecular subtypes and the correlation between each molecular type and MRI findings. Methods Multimodality MRI date of 87 patients with breast cancer confirmed by pathology were retrospectively analyzed. According to the expression of estrogen receptors(ER),progesterone receptors(PR)and human epidermal growth factor receptor-2 (HER-2),the tumors were classified into triple-negative breast cancer,HER-2 overexpression,Luminal A and Lu-minal B subtypes. The MRI features of breast cancers of different molecular subtypes were compared. Results Among the 87 cases of breast cancer,luminal type A accounted for 29.9%(26/87),luminal type B accounted for 36.8%(32/87),HER-2 type accounted for 19.5%(17/87),and triple-negative type accounted for 13.8%(12/87). The average ADC value is 0.97 × 10-3 mm2/s;those whose irregular or edge burr like mass were more often Lu-minal type MRI,triple-negative breast cancer showed the edge smooth,clear boundary,annular enhancement, more easily showed enhanced mode of TIC type Ⅲ. The mean ADC values of type Luminal and HER-2 over-expres-sion were lower than the mean ADC values of the triple-negative type. Conclusion The different molecular sub-types of breast cancer MRI morphologic and hemodynamic characteristics and the value of ADC has certain charac-teristics. The MRI features of breast cancer can be predicted to analyze the molecular typing,providing a reference for clinical treatment.
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Objective To explore the clinical effect of precise radiotherapy in the treatment of cancer in elderly patients. Methods We selected 88 elderly patients with advanced cancer at our hospital from January 2012 to December 2015.The patients were assigned into a control group(n＝44) treated with conventional radiation therapy and an intervention group (n＝44)receiving precise radiation therapy.Clinical effects and treatment reactions and adverse events were compared between the two groups. Results The total effective rate was higher in the intervention group than in the control group ,but the difference was not significant [40.9%(18/44)vs 56.8%(25/44) ,χ2＝ 2.228 ,P ＝0.135] .The control rate of clinical diseases was higher in the intervention group [77.3%(34/44)]than in control group[56.8%(25/44)](χ2＝ 4.166 ,P＝ 0.041).The incidence of adverse reactions was significantly lower in the intervention group [43.2%(19/44 )] than in the control group [68.2%(30/44)] ,(χ2＝ 5.572 ,P ＝ 0.018 ). Conclusions Precise radiotherapy has a precisely clinical efficacy and a lower incidence of adverse events. It is worth recommending and generalizing.
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Objective To explore clinical value of magnetic resonance imaging (MRI) in preoperative risk assessment and choice of operation scheme for knee cartilage injury.Methods A retrospective study was conducted of the 69 cases of knee cartilage injury which had been confirmed by surgery between January 2013 and June 2014.They were 29 males and 40 females,aged from 15 to 76 years (average,46.9 years).All cases underwent preoperative 1.5 T MRI by a special diagnostic instrument for limbs.The injury was assessed after MRI according to the Outerbridge criteria to evaluate surgical risks and choose an appropriate operation scheme (drilling,micro-fracture or autoallergic cartilage grafting).The intraoperative observations were compared with the preoperative images.Results MRI found in the 69 patients 345 cartilage surfaces,of which 208 were abnormal.Of the abnormal ones,75 (21.7％) were grade Ⅰ which presented with intact or slightly eminent contour and dots or patches of low or high signals in the cartilage;39 (11.3％) were grade Ⅱ which presented with thinned cartilage,defects ＜ 50％ of the full thickness,or (and) indented or wavy cartilage surface,dots or patches of low or high signals in the cartilage,and dropsy signals in cavity;43 (12.5％) were grade Ⅲ which obviously thinned cartilage,defects ＞ 50％ of the full thickness,and massive dropsy signals in cavity;51 (14.8％) were grade Ⅳ which presented with full thickness defects of cartilage,subchondral bone exposure beneath the defcts,and abnormal adjacent tissues.The preoperative findings were in agreement with what were observed during surgery in terms of number and extent of cartilage injury.Conclusion Because MRI can exactly display knee cartilage injury in terms of location,degree,and size,it provides solid evidence for preoperative risk assessment and choice of operation scheme for knee cartilage injury.
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Objective To explore the image manifestation and sensitivity of X ray,CT and MRI in pulmonary cancer of mediastinal type.Methods The clinical data of 31 patients with pulmonary cancer of mediastinal type were retrospectively analyzed.All 31 patients underwent X ray and plaiu CT scan,and 7 cases of them also underwent enhanced CT scan.21 patients underwent plain MRI and 3 of them also underwent enhanced MRI scan.The image manifestation and sensitivity of X ray,CT and MRI were analyzed.Results In 31 cases,there were 18 cases of central type lung cancer and 13 cases of peripheral lung cancer which confirmed by operation.The common manifestation of X ray in central type and peripheral lung cancer showed that mediastinal became wider and the trachea was pushed.In CT manifestation,the margin of tumor was irregular.Tumors demonstrated sublobe,sentus and lymphadenectasis of mediastinal lymph node.Some patients accompanied by obstructive pneumonia and atelectasis.MRI could accurately display tumor invading in the chest wall,pleura and thoracic goiter beside CT image manifestation.The clinical diagnostic sensitivity of X ray,MRI and CT were 88％,100％ and 100％ respectively.The sensitivity of CT and MRI were significantly higher than that X ray (x2 =12.251,P ＜ 0.05).Conclusion The pulmonary cancer of mediastinal type is easily misdiagnosed.The clinical diagnosis accuracy can enhance by clinical symptoms combined with image manifestation of X ray,CT and MRI.
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[Objective] To evaluate the clinical value of diagnosing osteoporosis with vertebra bone mineral density(BMD) by measurement with quantitative computed tomography (QCT) . [ Method] BMD in of lumbar vertebrae (L<,1～4>)were measured by QCT in 53 healthy middleaged persons or elderly persons (group A) and 68 osteoporosis patients ( groupB) . [Result] BMD in group A declined obviously as age increasing with significant differences (P<0. 01) . In group B,all 68 patients showed osteoporosis according to the diagnostic standard of BMD≤x -2. OSD. Sixty patients showed osteoporosis ifthe diagnostic standard was set to BMD ≤ x -2. 5SD. The BMD values of different age group was lower than the bone quantityblock values. [Conclusion] As a method for diagnosing osteoporosis, QCT has advantages of high sensitation, being precise,being reproducible and is easy for applying. It would be more practical and could decrease mis - diagnosing if the diagnosticstandard was BMD≤x-2.OSD.
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[Objective]To analyze the relation of age and sex with the incidence of physical examinees with osteoporosis and low bone mass of vertebras.[Method]Quantitative CT(QCT) was used to examine and analyze the lumbar bone mineral density in 575 physical examinees.The data was analyzed by statistical software SAS 9.0.[Result]Bone mineral density(BMD)decreased with age after 50 years old.The occurrence rates of osteoporosis were 56.34% for females at 50-59 years,87.80% at 60-69 years,97.22% at 70-79 years and 100% at 80-89 years,25.44% for males at 50-59 years,50.64% at 60-69 years,66.66% at 70-79 years,and 90.91% at 80-89 years.[Conclusion]The incidence of osteoporosis is positively related with the age.The occurrence rate of osteoporosis increases with increasing age.It is obviously higher in females than in males.
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Objective To evaluate the clinical application of fast fluid-attenuated inversion recovery(FLAIR) pulse sequence in MRI study of ADE.Methods Thirty cases with ADE were studied with fast FLAIR sequence and T 2 weighted spinecho sequence.The results were compared in terms of image quality.Results We found the fast-FLAIR could suppress CSF signal effectively,and more lesions were displayed on FLAIR images than on turbo SE T 2-weighted images.The extent of the lesions and the contrast between lesions and normal brain tissue were demonstrated better with fast-FLAIR sequence.Conclusion The lesions in ADE are demonstrated on fast-FLAIR sequence better than on turbo SE T 2 weighted sequence and FAST-flair could be a complementing modality to display lesions in ADE.