The Predictive Value of Magnetic Resonance Imaging-based Texture Analysis in Evaluating Histopathological Grades of Breast Phyllodes Tumor / 한국유방암학회지

Purpose@#Knowing the distinction between benign and borderline/malignant phyllodes tumors (PTs) can help in the surgical treatment course. Herein, we investigated the value of magnetic resonance imaging-based texture analysis (MRI-TA) in differentiating between benign and borderline/malignant PTs. @*Methods@#Forty-three women with 44 histologically proven PTs underwent breast MRI before surgery and were classified into benign (n = 26) and borderline/malignant groups (n = 18 [15 borderline, 3 malignant]). Clinical and routine MRI parameters (CRMP) and MRI-TA were used to distinguish benign from borderline/malignant PT. In total, 298 texture parameters were extracted from fat-suppression (FS) T2-weighted, FS unenhanced T1-weighted, and FS first-enhanced T1-weighted sequences. To evaluate the diagnostic performance, receiver operating characteristic curve analysis was performed for the K-nearest neighbor classifier trained with significantly different parameters of CRMP, MRI sequence-based TA, and the combination strategy. @*Results@#Compared with benign PTs, borderline/malignant ones presented a higher local recurrence (p = 0.045); larger size (p < 0.001); different time-intensity curve pattern (p = 0.010); and higher frequency of strong lobulation (p = 0.024), septation enhancement (p = 0.048), cystic component (p = 0.023), and irregular cystic wall (p = 0.045). TA of FS T2-weighted images (0.86) showed a significantly higher area under the curve (AUC) than that of FS unenhanced T1-weighted (0.65, p = 0.010) or first-enhanced phase (0.72, p = 0.049) images. The texture parameters of FS T2-weighted sequences tended to have a higher AUC than CRMP (0.79, p = 0.404). Additionally, the combination strategy exhibited a similar AUC (0.89, p = 0.622) in comparison with the texture parameters of FS T2-weighted sequences. @*Conclusion@#MRI-TA demonstrated good predictive performance for breast PT pathological grading and could provide surgical planning guidance. Clinical data and routine MRI features were also valuable for grading PTs.

MRI diagnosis of abdominal pregnancy / 中国医学影像技术

Objective To observe the application value of MRI in diagnosis and clinical management of abdominal pregnancy.Methods MRI and clinical data of 5 patients with abdominal pregnancy proved surgically were analyzed retrospectively.MRI performances were analyzed and compared with findings in operation.Results Prenatal MRI correctly diagnosed abdominal pregnancy in all 5 patients,including 1 case of primary and 4 cases of secondary abdominal pregnancy.The position of uterine rupture was revealed in all 4 cases of secondary abdominal pregnancy.MRI performances of placenta conformed to operative findings in all 5 patients.A lot of fresh intra-abdominal hemorrhage was found in 1 case,oligohydramnion in 2 cases,and abnormalities of placenta and fetus in 2 patients,which were consistent with findings of operation.Conclusion Prenatal MRI offers a high accuracy rate in diagnosis of abdominal pregnancy.MRI can show fetus,placenta and the relationship with surrounding tissue,therefore being helpful to clinical management of abdominal pregnancy.