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Objective To explore the value of the minimum apparent diffusion coefficient (ADC-min) value in the diagnosis of ductal carcinoma in situ (DCIS) and invasive cancer of breast.Methods One hundred and forty nine cases of breast cancer verified by histopathology were included in this retrospective study.All the patients underwent dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) before the biopsy.The ADC min value and its correlation with invasive ductal carcinoma(IDC),DCIS and IDC-DCIS were analyzed.Results The mean ADC-min values for IDC,IDC-DCIS and DCIS were (0.95±0.16)×10-3 mm2/s,(1.07±0.13)×10-3 mm2/s and (1.24±0.18)×10-3 mm2/s,respectively.The ADC-min value of the three groups showed an increasing trend and there were significant differences (F=32.08,P＜0.01).The optimal cutoff ADC-min value was 1.02 × 10-3 mm2/s to differentiate DCIS from invasive cancer with a sensitivity of 95.0％ and a specificity of 63.6％.Conclusion The ADC min values are significantly different among IDC,IDC-DCIS and DCIS.It may be used as a reliable tool to differentiate DCIS and invasive cancer of breast.
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Objective To study the safety management and risk response of preoperative emergency in patients with cerebral hemorrhage. Methods 92 patients with intracerebral hemorrhage were divided into two groups. The conventional group was treated with routine care in prehospital first aid. The prehospital intervention group used transport safety management and risk comprehensive response measures. The incidence of first aid consciousness,rapid response score, safe transshipment score, medical care score and the success rate of rescue and the incidence of medical disputes were compared between the two groups. The satisfaction of the family members of the patients with first aid treatment was analyzed. Results The score of first aid consciousness, rapid response score, safe transfer score,medical care score of the prehospital intervention group were (96. 24 ± 3. 91) points,(93. 98 ± 2. 72) points, (95. 26 ± 3. 57) points and (95. 72 ± 3. 02) points,respectively,which were significantly better than those of the conventional group [(83.12 ±3.15)points,(82.02 ±1.53)pointss,(83.52 ±2.92)points,(83.14 ±2.15)points, t=8. 629,8. 826,8. 042,8. 514,all P <0. 05]. The success rate of hospitalization of the prehospital intervention group was 95. 65%,which was higher than 78. 26% of the conventional group(χ2 =6. 133,P<0. 05). The incidence rate of medical disputes in the prehospital intervention group was significantly lower than that in the conventional group (χ2 =5. 145,P<0. 05). Among them,there were 9 cases of medical disputes in the conventional group,the incidence rate was 19. 57%. In the prehospital intervention group,there was 1 case of medical disputes,the incidence rate was 2. 17%. The satisfaction rate of prehospital emergency treatment in the prehospital intervention group was 95. 65%, which was significantly higher than 78. 26% in the conventional group (χ2 =6. 133,P<0. 05). Conclusion The safety management and risk response measures of preoperative emergency in patients with intracerebral hemorrhage are effective,which can effectively improve the success rate of cerebral hemorrhage rescue,improve nursing staff first aid consciousness and rapid response ability,improve medical care and transport safety,it is worthy of promotion.
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Objective To study the safety management and risk response of preoperative emergency in patients with cerebral hemorrhage. Methods 92 patients with intracerebral hemorrhage were divided into two groups. The conventional group was treated with routine care in prehospital first aid. The prehospital intervention group used transport safety management and risk comprehensive response measures. The incidence of first aid consciousness,rapid response score, safe transshipment score, medical care score and the success rate of rescue and the incidence of medical disputes were compared between the two groups. The satisfaction of the family members of the patients with first aid treatment was analyzed. Results The score of first aid consciousness, rapid response score, safe transfer score,medical care score of the prehospital intervention group were (96. 24 ± 3. 91) points,(93. 98 ± 2. 72) points, (95. 26 ± 3. 57) points and (95. 72 ± 3. 02) points,respectively,which were significantly better than those of the conventional group [(83.12 ±3.15)points,(82.02 ±1.53)pointss,(83.52 ±2.92)points,(83.14 ±2.15)points, t=8. 629,8. 826,8. 042,8. 514,all P <0. 05]. The success rate of hospitalization of the prehospital intervention group was 95. 65%,which was higher than 78. 26% of the conventional group(χ2 =6. 133,P<0. 05). The incidence rate of medical disputes in the prehospital intervention group was significantly lower than that in the conventional group (χ2 =5. 145,P<0. 05). Among them,there were 9 cases of medical disputes in the conventional group,the incidence rate was 19. 57%. In the prehospital intervention group,there was 1 case of medical disputes,the incidence rate was 2. 17%. The satisfaction rate of prehospital emergency treatment in the prehospital intervention group was 95. 65%, which was significantly higher than 78. 26% in the conventional group (χ2 =6. 133,P<0. 05). Conclusion The safety management and risk response measures of preoperative emergency in patients with intracerebral hemorrhage are effective,which can effectively improve the success rate of cerebral hemorrhage rescue,improve nursing staff first aid consciousness and rapid response ability,improve medical care and transport safety,it is worthy of promotion.
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Objective To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients.Methods Forty patients with pathologically proven breast Cancer underwent contrast-enhanced spiral CT of tbe breast and axilla,13 of them also underwent PET-CT examination.One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT,while 57 lymph nodes were found in the 13 patients through PET-CT.Three radiologists rated the lymph nodes found in CT images on a five-point scale.If the score was equal to or greater than 3,it was defined as positive (metastatic),otherwise negative.Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images.The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results.The relative value of CT and PET-CT was analyzed.Exact probability statistics were employed.Results One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT,91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT,99 were positive and 59 were negative pathologicall.A total of 57 lymph nodes were found by PET-CT.Thirty-nine of them were defined as positive and 18 as negative.Among the lymph nodes found in PET-CT,39 were positive and 18 were negative pathologically.The sensitivity,specificity,accuracy,positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%,94.91%,91.14%,96.70%,and 83.58%,respectively.The sensitivity,specificity,accuracy,positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%,94.44%,96.49%,97.44%,and 94.44%,respectively.PET-CT had no significant difference with spiral CT in sensitivity,accuracy,positive and negative predictive values for detection of axillary lymph nodes in breast cancer.But there was significant difierence between PET-CT and CT in negative predictive value(P＜0.05).Conclusions Both helical CT and PET-CT were the efficient methods in predicting the axillary lymph node status in breast cancer patiens.The negative predictive value of PET-CT was higher than that of helical CT.PET-CT has a better predictive ability than CT for the presurgical evaluation for breast cancer patients.
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Objective To evaluate the ability of the artificial pneumothorax CT examination in detection and diagnosis of pleural metastatic tumor.Methods A retrospective study of 14 patients with pleural effusion using artificial pneumothorax CT examination was conducted.Results Six of the 14 patients were found to have a nodule or nodules on the pleura.The pleural metastatic tumors of 3 cases were from the lung cancers and another 3 from breast cancers were proved histologically.Conclusion The artificial pneumothorax CT examination is a effective and simple method in detecting of pleural metastatic tumor.