RESUMO
Objective:To evaluate the diagnostic value of spectral CT calcium suppression (CaSupp) technique in acute and chronic thoracolumbar compression fractures.Methods:A total of 31 patients with thoracolumbar compression fractures were given spectral CT and MR scans from March to October 2020 in the Second Hospital of Shanxi Medical University. Acute and chronic vertebral fractures were diagnosed by doctor A and B based on CaSupp diagram, and the consistency between the two doctors was evaluated by Kappa test. CT values of fractured vertebra and adjacent normal vertebra were measured on conventional CT and CaSupp graphs respectively, and the CT value difference between fractured vertebra and adjacent vertebra was calculated. Independent sample t-test was used to compare the conventional CT value and CT value difference, CaSupp CT value and CT value difference between acute and chronic fractured vertebra. Using MRI as the gold standard, the ROC curves were drawn to evaluate the subjective diagnostic efficacy of physicians and the diagnostic efficacy of each quantitative parameter. DeLong test was used to compare the area under the curve (AUC) of each quantitative parameter in pairs. Results:The number of vertebral bodies in acute and chronic compression fractures diagnosed by MRI was 48 and 11 respectively. The Kappa value of subjective diagnosis of acute and chronic vertebral fractures by doctors A and B was 0.782, and the AUC, sensitivity, specificity were 0.882 and 0.857, 85.4% and 89.6%, 90.9% and 81.8%, respectively. The differences of conventional CT value, CaSupp CT value and CaSupp CT value difference between acute and chronic compression fractures were statistically significant (all P<0.05), and the AUC values of conventional CT value, CaSupp CT value, conventional CT value difference and CaSupp CT value difference were 0.824, 0.930, 0.706 and 0.934, respectively. Pair comparison showed that the AUC of the CaSupp CT value and CaSupp CT value difference was greater than that of conventional CT value difference, with statistically significant differences ( Z=2.014, P=0.044, Z=2.028, P=0.043), while there were no statistically significant differences between other AUC values (all P>0.05). Conclusion:The dual-layer detector spectral CT CaSupp technique has high value in differentiating acute and chronic thoracolumbar compression fractures, and the CaSupp CT value and CaSupp CT value difference are recommended for diagnosis.
RESUMO
Objective To study the value of breast vascularity in differential diagnosis of benign and malignant breast lesions. Methods The data of 37 patients with benign and malignant breast lesions in the Second Hospital of Shanxi Medical University from February 2017 to November 2017 were respectively analyzed. The number, diameter, length and breast-feeding arteries of bilateral breast vessel were recorded in the maximal intensity projection (MIP) of magnetic resonance imaging (MRI) and were scored according to Sardanellie. The patients were divided into the benign group and the malignant group according to the pathological results. Besides, ≥2 cm group and <2 cm group was also divided according to the maximum diameter of lesions. The differences in number and score of vascularity in both groups were compared. And the diagnostic efficacy of MRI was evaluated based on Sardanellie score and breast-feeding arteries. Results There were no significant differences in the number and score of vascularity between bilateral breast in benign breast lesions group (1.11 ±0.35 vs. 1.22 ±0.45, t= 0.19, P= 0.85; 0.89 ±0.38 vs. 0.95 ±0.21, t= 0.25, P=0.80). The number and score of vascularity of the affected side were higher than those of the healthy side in breast malignant lesions group (2.61 ±1.29 vs. 0.61 ±0.21, t= 6.18, P= 0.00; 1.78 ±0.65 vs. 0.61 ±0.21, t=6.30, P=0.00 respectively). The number and score of vascularity were statistically different between benign and malignant breast lesions (t= 8.57, P< 0.001; t= 12.61, P< 0.001). The number of vascularity in the malignant group was higher than that in the benign group with the maximum diameter of lesion<2 cm (1.27 ± 0.59 vs. 2.57±0.98, t=90.5, P< 0.05), and there was no significant difference in the scores of vascularity in the malignant group and the benign group (1.09 ±0.43 vs. 1.86 ±0.38, t= 87.0, P> 0.05); The number and score of vascularity in the malignant group were higher than those in the benign group with the maximum diameter ≥2 cm (0.92±0.63 vs. 2.64±1.50, t=47.5, P<0.05; 0.92±0.33 vs. 1.73±0.79, t=53.5, P< 0.05). There was no significant improvement in the diagnostic efficacy of MRI based on the score of vascularity and positive breast-feeding arteries in the identification of benign and malignant lesions when the maximum diameter of lesions were<2 cm, and it had a high diagnostic efficacy when the maximum diameter of lesions were ≥2 cm. Conclusions The vascularity of breast can be clearly seen by using breast dynamic contrast enhanced (DCE) MRI. The increase and score of vascularity in the differential diagnosis of benign and malignant breast lesions have a certain application value. The positive of breast-feeding arteries may increase the diagnostic efficiency of MRI.