Digital breast tomosynthesis for diagnosing non-calcified masses in dense breasts / 中国医学影像技术

Objective To analyze the clinical value of digital breast tomosynthesis (DBT) compared with digital mammography (DM) and ultrasound for diagnosing non-calcified masses in dense breasts.Methods Images taken with DBT,DM and ultrasound of 1144 patients with non-calcified masses in dense breasts were retrospectively analyzed using breast imaging reporting and data system (BI-RADS).Taking histopathologic results as golden standards,the detection rate and diagnostic accuracy,sensitivity,specificity,false negative and BI-RADS category were evaluated and compared statistically.Results The detection rate of DBT,DM and ultrasound for non-calcified massed in dense breasts was 86.62％ (991/1 144),77.80％ (890/1 144) and 99.65％ (1 140/1 144),respectively (P＜0.05),while the diagnostic accuracy was 83.92％ (960/1 144),75.00％ (858/1 144) and 94.67％ (1 083/1 144),respectively (P＜0.01).The sensitivity of DBT,DM and ultrasound was 89.39％ (312/349),79.93％ (231/289) and 92.70％ (432/466),the specificity was 81.51％ (648/795),73.33％ (627/855) and 96.02％ (651/678),while the false negative rate was 10.60％(37/349),20.07％ (58/289) and 7.30％ (34/466),respectively.No significant difference was found for benign lesions among three examination methods (P=0.75),while there was significant difference for malignant lesions among three examination methods (P＜0.01),and the differences of ultrasonography with DM and DBT,DBT and DM in the for BI-RADS category of malignant lesions were statistically significant (all P＜0.016 7).Conclusion For suspected masses in dense breasts,DBT shows significant advantage than DM,while DBT has the similar advantage compared with ultrasound for the detection and diagnosis of non-calcified masses in dense breasts.

A Rare Intradural Extramedullary Calcifying Pseudoneoplasm of the Spine Presenting with Radiculopathy.

Aims: Calcifying pseudoneoplasms of the neuroaxis (CPN) are rare, poorly understood lesions of the central nervous system that pose a diagnostic challenge because they mimic the more common calcified lesions of the neuroaxis. We highlight the relevant clinical presentation as well as radiological and histopathological features unique to intraspinal CPNs. Presentation of Case: We present the case of a 44-year-old Hispanic male with lumbar radiculopathy, radiological features of an indolent, intradural extramedullary mass, and a histopathological evaluation consistent with CPN. The patient underwent successful surgical resection and remained neurologically intact at long-term follow-up. Discussion: Epidural CPNs have been described in the literature. However, intradural CPNs are exceedingly rare lesions, and as a result, are not routinely included in the differential diagnosis of calcified, intraspinal lesions. Although there are currently no consensus guidelines for the diagnosis and management of intraspinal CPNs, understanding the clinical presentation and radiological features of these lesions is crucial for spine surgeons and neurosurgeons because surgical resection may offer a cure. Conclusion: Calcifying pseudoneoplasms may present as intradural abnormalities that mimic more prevalent lesions such as meningiomas. Surgical resection should be considered as first-line treatment because it is associated with low morbidity and may be potentially curative.

Angiographically Occult Arteriovenous Malformation Mimicking Brain Tumor: Case Report

The authors report a case of angiographycally occult intracranial vascular malformation. The patient had huge calcified mass at left frontoparietal area. The preoperative diagnosis was a slowly growing benign tumor. The mass was very hard and so vascular malformation was not suspected even during the operation. Pathologic report revealed arteriovenous malformation.

A Case of Oligodendroglioma of the Cerebellar Vermis

In the posterior fossa rarely develops oligodendroglioma and a review of the literature yields reports of two cases in the 4th ventricle in Korea. The authors present a case of 65-year-old woman patient with only the symptoms of increased intracranial pressure such as headache, dizziness and vomiting in spite of a large, irregular calcified mass occupying the cerebellar vermis on the brain CT scan. The caudal portion of the tumor attached firmly to the floor of the 4th ventricle and the complete removal of the mass, associated with a good long-term prognosis, was not feasible.