Efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery arteriosclerosis obliterans: prospective randomized controlled triac / 南方医科大学学报

<p><b>OBJECTIVE</b>To compared the efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery occlusive disease.</p><p><b>METHODS</b>Forty-six patients were admitted for ipsilateral single or multiple superficial femoral artery and/or popliteal artery lesions (between 3 and 15 cm stenosis or occlusion), Rutherford grades 2 to 5, with or without other accompanying diseases in the Department of Interventional Vascular Therapy of the First Hospital of Nanjing between September, 2015 and December, 2016. The patients were randomly assigned into drug-coated balloon (DCB) group (n=23) and common balloon (CB) group (n=23). None of the patients had stent restenosis, aneurysms, acute thrombosis, pregnancy, life expectancy less than 1 year, or below-the-knee artery occlusion. The late lumen loss (LLL), improvement of the ankle brachial index (ABI), improvement of Rutherford grade, incidence of restenosis, thrombosis rate and amputation rate were compared between the two groups at 6 months after treatment.</p><p><b>RESULTS</b>The two groups of patients were comparable for general conditions, risk factors, and characteristics of the compromised vessels (P>0.05). Six months after treatment, the patients in DCB group showed significantly smaller LLL, more obvious improvement of the ABI and Rutherford grade, and lower restenosis rate and thrombosis rate than those in CB group (P<0.05). The amputation rates were similar between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>DCB shows obvious advantages over common balloon for treatment of superficial artery and popliteal artery arteriosclerosis obliterans in that it more effectively reduces LLL, restenosis rate and thrombosis rate and improves the ABI and Rutherford grade at 6 months after the treatment.</p>

Is There a Correlation between the Presence of a Spiculated Mass on Mammogram and Luminal A Subtype Breast Cancer?

OBJECTIVE: To determine whether the appearance of a spiculated mass on a mammogram is associated with luminal A subtype breast cancer and the factors that may influence the presence or absence of the spiculated mass. MATERIALS AND METHODS: Three hundred seventeen (317) patients who underwent image-guided or surgical biopsy between December 2014 and April 2015 were included in the study. Radiologists conducted retrospective assessments of the presence of spiculated masses according to the criteria of Breast Imaging Reporting and Data System. We used combinations of estrogen receptor (ER), progesterone receptor (PR), human epithelial growth factor receptor 2 (HER2), and Ki67 as surrogate markers to identify molecular subtypes of breast cancer. Pearson chi-square test was employed to measure statistical significance of correlations. Furthermore, we built a bi-variate logistic regression model to quantify the relative contribution of the factors that may influence the presence or absence of the spiculated mass. RESULTS: Seventy-one percent (71%) of the spiculated masses were classified as luminal A. Masses classified as luminal A were 10.3 times more likely to be presented as spiculated mass on a mammogram than all other subtypes. Patients with low Ki67 index (< 14%) and HER2 negative were most likely to present with a spiculated mass on their mammograms (p <0.001) than others. The hormone receptor status (ER and PR), pathology grade, overall breast composition, were all associated with the presence of a spiculated mass, but with less weight in contribution than Ki67 and HER2. CONCLUSION: We observed an association between the luminal A subtype of invasive breast cancer and the presence of a spiculated mass on a mammogram. It is hypothesized that lower Ki67 index and HER2 negativity may be the most significant factors in the presence of a spiculated mass.

A model of lumbar disc degeneration on the early stage in rhesus monkey with minimally invasive technique / 中华外科杂志

<p><b>OBJECTIVE</b>To establish a novel model of lumbar disc degeneration on the early stage in the rhesus monkey using percutaneous needle puncture guided by CT.</p><p><b>METHODS</b>(1) Thirteen rhesus monkeys aged from 4 to 7 years, female 7 and male 6 were selected for establishing a model of the early stage of lumbar disc degeneration. (2)13 monkeys, 91 discs were divided into 3 groups: 64 discs from L1/2 to L5/6 were percutaneous punctured with a needle 20G as experimental group and 1 disc with a needle 15G as puncture control group and 26 discs were not be punctured from L6,7 to L7-S1 as control group. (3) Lumbar disc localization for needle puncture was guided by CT. All discs were examined by MRI, the HE, Masson's trichrome, Safranine-O and immunohistochemical staining of type II collagen before disc puncture and after puncture at 4, 8 and 12 weeks.</p><p><b>RESULTS</b>MRI: (1) Experimental group: Pfirmann's Grade I was shown at postoperation 4, 8 and 12 weeks; (2) Puncture control group: Grade III was shown at postoperation 4 weeks and Grade IV at 8 weeks; (3) CONTROL GROUP: Grade I was shown at postoperation 4, 8 and 12 weeks. Histological examination: (1) In experimental group, there was no any change at postoperation 4 weeks, and the cell population of the nucleus was decreased at 8 weeks and more decreased at 12 weeks in HE. (2) There was no any change at postoperation 4 weeks, the clefts among the lamellae of the annulus fibrosus (AF) were shown at 8 weeks and more wider of the clefts of AF at 12 weeks in Masson's trichrome. (3) No any change was shown at postoperation 4 weeks, proteoglycan were progressively decreased at 8 and 12 weeks in Safranine-O. (4) No statistically significant difference in positive rate was observed at 4 and 8 weeks compared with control group in immunohistochemical staining of type II collagen. There was statistical difference at 12 weeks compared with control group (P<0.05). In puncture control group postoperation 8 weeks, the morphology of cell of nucleus pulposus was not clear in HE. The wider clefts of lamellae of the AF were shown in Masson's trichrome. The proteoglycan was obviously decreased in Safranine-O. Immunohistochemical staining collagen II synthesized was decreased. In normal control group, no any change was shown at 4, 8 and 12 weeks.</p><p><b>CONCLUSIONS</b>The degeneration of lumbar intervertebral disc on the early stage could be induced by the percutaneous needle puncture (20G) to the annulus fibrosus. The assessment of disc degeneration on early stage is not shown on MRI and only confirmed by histological examination.</p>

Radiological diagnosis of primary malignant fibrous histiocytoma of bone / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the radiological diagnosis of primary malignant fibrous histiocytoma (MFH) of bone.</p><p><b>METHODS</b>Sixteen patients with biopsy-or surgery-confirmed MFH received both plain X-ray and CT examinations, among whom six patients simultaneously received MRI. The imaging features were analyzed and the differential diagnoses were assessed.</p><p><b>RESULTS</b>(1) Plain X-ray findings: All these lesions showed irregularly osteolytic, accompanied by cortical destruction. Five patients had varied degrees of cortical expansion, 12 had large soft tissue masses adjacent to the lesions, and only 2 had periosteal reaction. (2) CT findings: All lesions were osteolytic areas but had no evidences that its internal architecture had been replaced by soft tissue mass, and the cortical adjacent to the lesions were permeative osteolysis. Four patients had internal or marginal crest within the lesions and marginal inconsecutive osteosclerosis. Twelve had large soft tissue masses but without any calcification and residual architecture adjacent to the lesions, among which 3 patients had solitary or multiple cystic attenuation areas within the masses. No clear periosteal reaction was observed on CT. (3) MRI findings: All of lesions in 6 patients who received MRI showed inhomogeneous long T1 and long T2 abnormal signal intensity with soft tissue masses adjacent to the osteo-destructions.</p><p><b>CONCLUSIONS</b>The imaging manifestations of MFH were specific to some extent. Combined utilization of plain X-ray, CT, and MRI is helpful for the diagnosis and differential diagnosis of MFH.</p>

Comparative imaging study for soft tissue changes in osteomyelitis and malignant bone tumor / 中华放射学杂志

Objective To investigate the value of the imaging findings of soft tissue abnormality in the differential diagnosis between osteomyelitis and malignant bone tumor.Methods The CT and MRI findings of soft tissue changes in 57 cases of osteomyelitis and 70 cases of malignant bone tumor were retrospectively defined,observed,recorded and statistically analyzed.Results In 57 cases of osteomyelitis, 54 cases were examined with CT,and soft tissue swelling was presented in 52 cases (degree Ⅰin 19 cases, degreeⅡin 16 cases,degree Ⅲin 17 cases).Abscess-like cysts in soft tissue occurred in 6 cases,masses in 5,air in 1,fat-fluid level in 1 and sinus tract in 1.Among 14 cases examined with MR imaging,soft tissue swelling was presented in all cases (degreeⅠin 2 cases,degree Ⅱin 6 cases and degree Ⅲin 6 cases). Abscess-like cysts appeared in 3 cases and showed high signal in diffusion weighted imaging, mass in Ⅰand fat-fluid level in 1.Among 54 cases examined with CT in 70 cases of malignant bone tumor, soft tissue swelling was presented in 44 cases (degreeⅠin 29 cases,degreeⅡin 12 cases,degreeⅢin 3 cases).Soft tissue masses appeared in 49 cases,bone shell and shell-like calcification in 16 cases and neoplastic bone and neoplastic calcified cartilage within soft tissue mass in 25 cases.Among 49 cases examined with MR imaging,soft tissue swelling was presented in 46 cases (degree Ⅰin 21 cases,degreeⅡin 17 cases and degree Ⅲin 8 cases),and soft tissue masses appeared in 43 cases.The degree of soft tissue swelling and the occurrence of abscess-like cyst,mass,bone shell or shell-liked calcification in the rim of mass,neoplastic bone or neoplastic calcified cartilage in masses showed significant difference(P