RESUMEN
Objective To evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) and its combination with DWI and proton MR spectroscopy (1H-MRS) in differentiating malignancy from benign breast lesions. Methods Fifty-three patients with 38 histopathologically confirmed malignant and 15 benign breast lesions were retrospectively studied. The patients were examined by breast MRI at 3.0 T prior to operation, including conventional T1WI, fat-suppression imaging, DWI, DKI and 1H-MRS. The shape and margin of breast lesions, and their corresponding mean values for ADC, mean kurtosis (MK) and mean diffusivity (MD) were determined by two blinded radiologists in consensus. The presence or absence of choline (Cho) peak was identified using LCModel software. Independent-samples t test or χ2 test was performed for the comparison of clinical characteristics, shape and margin of lesions, and imaging parameters between malignancy and benign lesions. ROC analysis was performed to evaluate the diagnostic accuracy of DKI, DWI and 1H-MRS alone or in combination, in comparison with the histopathologic findings. Results The onset age of breast malignancy was higher than that of benign ones, and the difference has statistical significant (P0.05). The mean ADC,MD and MK of benign lesions were(1.464 ± 0.348)× 10-3mm2/s,(1.726 ± 0.268)× 10-3mm2/s and(0.692 ± 0.227), the mean ADC,MD and MK of malignancy were(0.963 ± 0.170)× 10-3mm2/s,(1.158 ± 0.262)× 10-3mm2/s and(1.311 ± 0.218), respectively. Significant differences were obtained between benign and malignant lesions for all parameters (P<0.05).The area under the ROC curve (AUC) of ADC, MD and MK for differentiating malignancy from benign lesions was 0.913, 0.933 and 0.968, respectively. Taken the maximum Youden's index of MK (1.110) as the ROC optimal cut-off point, MK exhibited better diagnostic sensitivity, specificity and accuracy for distinguishing malignancy from benign lesions [89.5%(34/38),93.3%(14/15) and 90.6%(48/53), respectively], compared with MD and ADC. Multiparametric imaging with combination of DKI, DWI and 1H-MRS improves the diagnostic specificity (with the highest as 100.0%) but decreases the sensitivity (with the highest as 81.6% and lowest as 71.1% ), compare with the single parametric imaging. Conclusions MK generated from DKI enables differentiation of breast lesions with a higher diagnostic sensitivity and specificity than DWI and 1H-MRS. DKI combined with DWI and 1H-MRS increase specificity but decrease sensitivity for breast cancer characterization.
RESUMEN
Objective To study the values of the diagnosis of superficial carcinoma of stomach using digital radiography(DR). Methods Patients with superficial carcinoma of stomach( n = 62) were divided into two groups:group DR( n = 35, using digital radiography) and group control( n = 27, using traditional X ray machine). All pa-tients were undergone Gas-Barium double contrast radiograph examination before operation and confirmed by pathol-ogy. Results In group DR, the focuses of 32 patients were found and 3 lost. In group control, the focuses of 22 pa-tients were found and 5 lost. The detection rate of the two groups had significant difference( P < 0.01 ). Conclusion The application of DR could increase the detection rate of superficial carcinoma of stomach, meanwhile gastroscope and pathology biopsy were also important.
RESUMEN
Objective To discuss drug application and nursing experience during CT contrast enhancement in infants.Methods CT contrast enhancement with Ultravist,one of the non-ionic contrast media,was performed on 202 infants.Before examination,all the infants were calmed with Diazepam or Chloral Hydrate(10% in concentration).The doses of the drugs were determined by the weight of these infants.Results Non-ionic contrast media was not absolutely safe and a few infants had side effects.Only 7 infants had positive allergic tests.The results of CT contrast enhancement on 202 infants were satisfied.Conclusion During CT enhancement,appropriate use of contrast media and sedatives as well as proper nursing according to the infants’ age will get a better result.