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Objective:To investigate the diagnostic value of MRI in benign and malignant breast lesions with cluster ring enhancement.Methods:The imaging signs of 68 patients with clustered ring enhancement who underwent MRI examination due to clinical palpation, ultrasound or X-ray examination for suspected malignant lesions in Tangdu Hospital of Air Force Military Medical University from October 2017 to July 2019 were retrospectively analyzed. The differences between benign and malignant lesions in the distribution pattern, T2 lipid suppression signal intensity, time-signal intensity curve (TIC), ductal dilatation, peripheral gland edema, pectoralis major edema were compared using χ2 test or Mann-Whitney U test, and the risk factors of MRI imaging signs of malignant breast lesions were analyzed using binomial logistic regression model. Results:There were 68 cluster ring enhancement lesions in 68 patients, all of which were single lesions, among which 18 cases (26.5%) were benign, and the common lesions were plasma cell mastitis (9 cases). Fifty cases (73.5%) were malignant, and the most common type was invasive breast cancer (40 cases). Imaging features of plasma cell mastitis showed cluster ring enhancement, regional distribution, slightly high signal on fat suppression T2 image, type Ⅲ TIC, with ductal dilatation, edema of peripheral glands and pectoralis major. Imaging features of invasive breast cancer showed cluster ring enhancement, regional distribution, iso-signal on fat suppression T2 image, type Ⅲ TIC, no ductal dilatation, and edema of peripheral gland and pectoralis major. There were statistically significant differences in the intensity of fat-suppression T2 signal ( Z=3.003, P=0.003) and duct dilatation ( χ2=7.174, P=0.007) between benign and malignant lesions. There were no significant differences in distribution ( χ2=5.510, P=0.313), TIC type ( χ2=3.538, P=0.133), peripheral gland edema ( χ2=0.164, P=0.686) and pectoralis major edema ( χ2<0.001, P>0.999). The analysis of binomial logistic regression model showed that fat-suppression T2 iso-signal ( OR=0.182, 95% CI: 0.036-0.914, P=0.039) and no ductal dilatation ( OR=0.198, 95% CI: 0.047-0.846, P=0.029) were the risk factors for breast malignant lesions. Conclusion:Breast cancer MRI findings of cluster ring enhancement, fat-suppression T2 iso-signal and no ductal dilatation are related risk factors for malignant breast lesions. MRI is helpful for early detection and diagnosis of breast lesions.
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Objective@#To compare the application of dynamic contrast-enhanced magnetic resonance imaging (MRI) and conventional MRI in the detection of hepatocellular carcinoma (HCC) lesions before and after transcatheter arterial chemoembolization (TACE) treatment and evaluation of the effect of TACE treatment, thus to judge its application value, and to provide guidance for early clinical diagnosis.@*Methods@#Seventy-six patients with HCC who underwent TACE in Pingyang Hospital Affiliated to Wenzhou Medical University from January 2018 to December 2018 were selected in the research.According to the random number table method, 76 patients were randomly divided into control group and study group, with 38 cases in each group.The control group was examined by conventional MRI, while the study group was examined by dynamic enhancement of MRI.The lesions were observed before and after treatment, and Ktrans, Kep and ve of the two groups were recorded before and after treatment.The accuracy, sensitivity and specificity of the two groups were compared.@*Results@#Before and after treatment, the total detection rates of the study group (92.05%, 100.00%) were significantly higher than those of the control group (80.85%, 71.43%) (χ2=16.489, 15.246, all P<0.05). Before treatment, the Ktrans, Kep, ve equivalents between the two groups had no statistically significant differences (t=0.915, 0.448, 0.354, all P>0.05). After treatment, the Ktrans and Kep values of the two groups were significantly decreased, and the Ktrans[(0.419±0.101)min] and Kep[(1.073±0.237)min] values of the study group were significantly lower than those of the control group [(0.647±0.128)min, (1.158±0.221)min], the differences were statistically significant (t=9.485, 5.642, all P>0.05). There was no statistically significant difference in ve value between the two groups (t=1.025, P>0.05). The accuracy and sensitivity of detection in the study group (92.11%, 97.37%) were significantly higher than those in the control group (81.58%, 84.21%), and the specificity (94.74%) of the study group was significantly lower than that of the control group (97.37%) (χ2=17.186, 14.453, 6.489, all P<0.05).@*Conclusion@#Dynamic contrast-enhanced MRI is more effective in the detection of HCC patients before and after TACE treatment.It is convenient to provide guidance for treatment and has higher clinical application value.It is worthy of popularizing.
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Objective To explore the performance of meningiomas in MRI dynamic enhancement and DWI sequence,and to improve the accuracy of differential diagnosis of benign and malignant meningiomas.Methods Meningioma MRI data,which were pathology proved by the Guilin medical college affiliated hospital at different levels(Ⅰ,Ⅱ and Ⅲ),were retrospectively analyzed.The enhancement of meningiomas at all levels and the extent of edema were summarized,at the meantime the dynamic enhancement perfusion parameters and ADC values of meningioma MRI meningioma were contrastively analyzed.Results There were 30 cases of meningioma located in the brain falcus,27 cases of meningioma located in the sagittal sinus,10 cases of meningioma located in the cerebellopontine angle and 6 cases of meningioma located in other parts.The difference of ADC value between grade Ⅰ meningiomas and grade Ⅲ meningiomas was statistically significant different[(1.253±0.123)×10-3 mm2/s vs.(0.891±0.103)×10-3 mm2/s,P<0.05].The relative blood flow(rCBF)and relative blood volume(rCBV)of grade Ⅰ meningiomas were significantly lower than those of grade Ⅲ meningiomas(P<0.05).Conclusion MRI dynamic enhancement combined with DWI can accurately identify grade Ⅰ meningiomas and grade Ⅲ meningiomas,and it is necessary that the assessment of its classification should be appropriately considered to the higher level for patients who do not have a characteristic manifestation of meningioma in the preoperative.
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Objective To study the value of magnetic resonance diffusion weighted imaging (DWI)and dynamic enhanced imaging (DCE)in endometrial carcinoma staging.Methods 200 cases with endometrial carcinoma were selected,DWI and DCE were given before operation.The diagnostic value of two kinds of examination methods for the diagnosis of endometrial carcinoma in general and basic level was compared.Results The overall accuracy of muscle invasion of magnetic resonance DWI was 91.5%(183 /200),which was significantly higher than 77.5%(155 /200)of magnetic resonance DCE,the difference was statistically significant (χ2 =11.231,P <0.05 ).The accuracy,sensitivity and positive predictive value of the magnetic resonance DWI superficial and deep muscular layer were significantly higher than those of the magnetic resonance DCE (χ2 =9.283,8.231,9.021,8.927,8.142, 9.405,all P <0.05).Compared with pathological results,Kappa value of magnetic resonance DWI was 0.807,Kappa value of magnetic resonance DCE was 0.587.Conclusion Magnetic resonance DWI compared with magnetic reso-nance DCE,the accuracy and sensitivity of the infiltration of endometrial carcinoma was higher.
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Pancreatic endocrine tumors (PETs) are very rare and are divided into functional and nonfunctional tumors.Their clinical manifestations vary,and imaging diagnosis easily led to missing diagnosis and misdiagnosis for PETs.With the development of MRI technology,especially application of fat suppression techniques,diffusion weighted imaging (DWI) and dynamic enhanced magnetic resonance imaging (DEMRI) are of great value on imaging diagnosis and differential diagnosis for PETs.The clinical data of 13 patients with PETs who were admitted to the Central Hospital of Enshi Autonomous Prefecture from June 2007 to December 2011 were retrospectively analyzed,and their MRI imaging features were studied.The diagnostic values of MRI,especially DWI and DEMRI for PETs were investigated.
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Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.
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Objective To investigate the application of MR 3D-FLASH dynamic enhanced scanning in the breast diseases. Methods 108 women (35～76 years old,mean,47 years) with breast diseases confirmed by pathology were examined by using Siemens 1.0T superconducting MRI and double breast circles.Plain MR imaging performed first,then contrast-enhanced MR scans were followed with 3D FLASH sequence,and the images were subtracted.Results Among 108 cases,62 cases were benign and 46 cases were breast cancer,the diagnosing accurate rate of MR imaging was 81.5% compared with pathology pre-operation.Conclusion 3D-FLASH enhanced MR scan is the most valuable sequence in diagnosing breast lesions.
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Objective To value diffusion-weighted imaging and ADC value measurement of benign and malignant axillary lymph node identification value. Methods From 2006-06 to 2008--02, by collecting in the hospital for breast dynamic con-trast-enhanced scans and diffusion-weighted imaging, 217 lesions in 56 cases with a clear outcome of the surgery and pathology and/or needle biopsy results were retrospectively analyzed.Results The DWI could accurately show the lymph node of the armpit abnormality, 163 cases of 47 breast cancer cases with lymph node metastasis showed high signal in DWI image that did not decrease with increasing b value, similar to the 54 cases of 9 benign enlarged responsive prolifer-ative lymph nodes. But the former showed higher signal than the later. The ADC values were(1.017±0.114)×10-3mm2/s and (1.905±0.136)×10-3mm2/s respectively, and showed significant difference between two groups (P<0.05). Conclusion The dynamic contrast-enhanced subtraction MR technology benign and malignant breast lesions has high diagnosis and differ-ential diagnosis importance. DWI and ADC value measurement is a safe, non-invasive, accurate and rapid diagnosis of metastasis axillary lymph nodes and benign proliferative response of the lymph nodes means.
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Objective To study the value of the early enhanced morphology in three dimensional dynamic contrast-enhanced and digital subtraction MRI in diagnosing breast cancer.Methods Three dimensional dynamic contrast-enhanced and digital subtraction MRI of breast neoplasm in 46 patients(52 lesions)verified by histopathology were performed before operations.MR imaging data were analysed.On the base of early-phase enhanced rate,peak time,blood vessel morphology and time-signal intensity curve,the diagnostic values of the early enhanced morphology of lesions were evaluated.Results In the 37 malignant breast lesions,31 lesions were enhanced from the center to the margin(83.8%,31/37),14 benign breast lesions were enhanced from the margin to the center(93.3%,14/15).The special features of breast cancer in three dimensional dynamic contrast-enhanced and digital subtraction MRI were circular enhancement and the contrast medium filled from the margins to the centre of lesions in middle-later phase,its diagnostic sensitivity,specificity and accuracy were 97.3%,93.3% and 96.2% respectively.Conclusion The morphological features of three dimensional dynamic contrast-enhanced and digital subtraction MRI has obvious advantages in diagnosing breast cancer.
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Objective To study the diagnostic value on mammary gland focal benign and malignant with MRI digital sub- traction. Methods By analyzing 109 histopathology cases of breast neoplasm which can be use three dimensional dynamic contrast and MRI digital subtraction. Based on early-phase enhancement rate peak time, time-signal intensity curve and enhanced lesions way, the diagnostic value on it was evaluated. Results The specificity signs of breast carcinoma are en- hanced ways on MRI enhancement scanning. The filling type is contrast agent filled from edge to centre. The sensitivity is 82.9%; specificity is 79.0%; accurate rate is 80.7%. Conclusion The aggrandizement form on filling type of breast MRI digital subtraction scanning focus has obvious advantages in breast carcinoma diagnosis.