Impact of breast density on computer-aided detection (CAD) of breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the impact of breast density on computer-aided detection (CAD) for breast cancer and the CAD false-positive rate of normal controls.</p><p><b>METHODS</b>Two hundred and seventy-one histologically proven breast malignant lesions (from Feb. 2008 to Dec. 2009) and 238 randomly selected normal cases were classified by mammographic density according to the American College of Radiology breast imaging reporting and data system (BI-RADS). Mammograms of BI-RADS 1 or BI-RADS 2 density were categorized as non-dense breasts, and those of BI-RADS 3 or BI-RADS 4 density were categorized as dense breasts. Full-field digital mammography (GEMS Senographe) were performed in all patients and controls with craniocaudal (CC) and mediolateral oblique (MLO) views. Then the image data were transferred to review workstation (SenoAdvantage), and the lesions were marked by Second Look Digital CAD system (version 7.2, iCAD). The differences of sensitivity and false-positive rate between dense and non-dense breasts were compared.</p><p><b>RESULTS</b>Overall, the sensitivity of CAD in detection of cancers was 84.1% (228/271), there was a statistically significant difference in CAD of cancers in dense versus non-dense breasts (P = 0.015). The sensitivity of CAD in detection of mass cancers was 76.5% (186/243), in detection of calcification cancers was 79.1% (125/158), there was no statistically significant difference in CAD performance for the detection of mass cancers versus calcification cancers (P = 0.547). There was a significant difference in the CAD performance for the detection of mass cancer cases in non-dense versus dense breasts (P = 0.001), but no significant difference in the CAD for the detection of calcification cancers in non-dense versus dense breasts (P = 0.216). In the controls, the distribution of mass false-positive marks did not differ significantly between non-dense and dense breast tissue cases (P = 0.207), but the distribution of calcification false-positive marks differed significantly between non-dense and dense breast tissue cases (P = 0.001). There was a statistically significant difference of false-positive marks in non-dense versus dense breasts (P = 0.043).</p><p><b>CONCLUSIONS</b>The sensitivity of CAD in the detection of breast cancers is impacted by breast density. There is a statistically significant difference in the CAD performance for the detection of cancer cases in non-dense versus dense breasts. The false-positive rate of CAD is lower in dense versus non-dense breasts. It appears difficult for CAD in the early detection of breast cancer in the absence of microcalcifications, particularly in dense breasts.</p>

Clinical application of interventional therapy liver in orthotopic hepatic venous outflow obstruction following liver transplantation / 中华器官移植杂志

Objective To summary the clinical applied value of interventional therapy in hepatic venous outflow obstruction after orthotopic liver transplantation(OLT).Methods The clinical data of 27 patients suspect with hepatic outflow obstruction out of OLT patients were analyzed retrospec- tively.Most of them presented with liver dysfunction,like ascites,jaundice,or hydropsia of lower ex- tremity as BCS.These patients accepted venography and endovascular treatment if venous outflow ob- struction was found.Results By venography,one case of thrombus in inferior vena cava,one case of hepatic vein stenosis,13 cases of inferior vena cava stenosis(3 cases were associated with hepatic vein stenoses)were identified.Stent implantation was successfully performed on 10 patients,and balloon angioplasty on 4 patients.Rapid,dramatic resolution of symptoms was achieved in those patients. Hepatic vein restenosis occurred in one case 8 months after balloon dilatation,and treated with stent implantation.Inferior vena cava restenosis occurred in one case 2 years after balloon dilation,and trea- ted with another balloon expanding.Patients remained completely asymptomatic at 4 months to 5 years of follow-up.Conclusion The venacavographic balloon angioplasty and metallic stent replacement are safe and useful for post-OLT with venous outflow obstruction.

Experimental study of a closed-chest pulmonary embolism-reperfusion injury canine model by means of Swan-Ganz catheter / 中华放射学杂志

Objective To establish a closed-chest pulmonary embolism-reperfusion animal model by Swan-Ganz catheter and to explore the mechanisms of pulmonary embolism(PE)-reperfusion injury(RI). Methods Experiments were made on 14 mongrel dogs,ranging in weight from 15 to 18 kg,anesthetized with 3% pentobarbital sodium.The dogs were intubated with I.D.7 endotracheal tubes.Under sterile conditions,a 7 F Swan-Ganz catheter via the external jugular vein was positioned in the unilateral pulmonary diaphragmatic lobe(DL)artery.Occlusion/reperfusion of the DL artery was controlled with 1.2 ml diluted contrast agent filled into/drawn from the balloon.After the 24 h PE,the balloon was deflated to result in 4 h reperfusion of the DL.Measurements of blood gases and tumor necrosis factor-?(TNF-?)were made at normal condition,at 24 h PE and at 4 h reperfusion.Thin-section CT scans were performed at normal condition,24 h PE,30 min,1,2,3 and 4 h reperfusion,respectively.At the end of each experiment, tissue specimens of bilateral diaphragmatic lobes were obtained for both wet/dry(W/D)weight ratio and for pathological study.Results Reperfusion pulmonary edema(RPE)was an acute,mixed,noncardiogenic edema that was observed in all 14 dogs who had been successfully established as PE/RI animal models.RPE demonstrated heterogeneous ground-glass opacifications that predominated in the areas distal to the recanalized vessels.It manifested pathologically as an edematous lung infiltrated by inflammatory cells.The mean ofPaO_2 and TNF-? of 4 h reperfusion was(81?4)mm Hg(l mm Hg=0.133 kPa)and(16.0? 2.5)pg/ml,which were significantly different(P

Study of diffusion tensor imaging in brain ringlike-enhanced lesions / 中华放射学杂志

Objective To evaluate diagnostic value of diffusion tensor imaging(DTI)in ringlike- enhanced lesions.Methods Nine abscesses,12 glioblastomas,10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI.Average diffusion coefficient(ADC)value,fractional anisotropy(FA)value and maps were calculated in the central portion and peripheral edema of the lesions. Results On DTI,the abscesses displayed as hyperintense signal with hypointense or isointense signal of edema;but glioblastomas and metastases all showed as hypointense signal with isointense or hypointense signal of edema.On ADC map,the abscesses showed as hypointense signal,the mean ADC value was (0.66?0.07)x10~(-3)mm~2/s,The mean ADC value were(2.50?0.11)x10~(-3)mm~2/s and(2.37?0.52)x10~(-3)mm~2/s for the glioblastomas and metastases,respectively,all demonstrated as hyperintense signal with slightly hyperintense signal of edema.The difference between abscess and necrotic tumors was statistically significant(F=108.80,P