Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement / 国际肿瘤学杂志

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.

Fibrous Meningioma with Ring Enhancement in Cerebellopontine Angle Region:Report of One Case / 中国医学科学院学报

Fibrous meningioma is a common subtype of meningioma. Contrast-enhanced scan typically shows evident homogeneous enhancement,while ring enhancement has not been described. In this article,we report a case of fibrous meningioma with ring enhancement in cerebellopontine angle region.

Multimodality MRI in diagnosis of breast lesions with ring enhancement / 中国医学影像技术

Objective To investigate the value of multimodality MRI in diagnosis of breast lesions with ring enhancement (internal enhancement pattern) on dynamic contrast enhanced (DCE) MRI.Methods Data of 67 patients with breast lesions confirmed by surgical pathology who underwent DCE MRI and DWI examinations were analyzed retrospectively.Finally,67 patients with breast lesions manifested as ring enhancement on DCE MRI were included in the study.According to the pathological findings,all patients were divided into benign group and malignant group.The overall morphology,morphology of "enhanced ring",time-signal intensity curve (TIC) types on DCE MRI,the distribution location of limited diffusion on DWI between the two groups were compared.Also the differences in semi-quantitative parameters on DCE-MRI and multi-point ADC values of the "enhanced ring" between the two groups were compared.Using pathological results as the dependent variables,indexes with statistical differences as the independent variables,the Logistic regression model was established to construct the newly combined parameters and to evaluate the diagnostic efficacy of the stepwise combined parameter.Results There were significant differences of different wall shapes concerning "enhanced ring" (x2 =14.19,P=0.001),wall nodules (x2 =12.48,P=0.001) and distribution locations of limited diffusion on DWI (x2 =19.60,P=0.003) between the two groups.There were also significant differences of the semi-quantitative parameters including early enhancement ratio (EER;t=2.35,P=0.02),maximum enhancement time (Tmax;t=-4.66,P=0.007),ADC ringi (t=1.35,P=0.001) and ADC ring wall(t=-2.88,P=0.005)between the two groups.The maximum Youden index of a newly-constructed parameter combination(morphological indexes of "enhanced ring"+distribution locations of limited diffusion on DWI+Tmax+ADCring inner) was 0.83 for combined diagnosis.The area under ROC curve was 0.87 (95％CI [0.82,0.91]),and the diagnostic sensitivity and specificity was 91.96％ and 91.31％,respectively.Conclusion Multimo dality MR can provide high diagnostic efficacy for breast lesions with ring enhancement

Clinics in diagnostic imaging (180). Ductal carcinoma in situ (DCIS)

A 26-year-old woman presented with a slow-growing right breast lump. Excision biopsy of the lump showed invasive ductal carcinoma with adjacent ductal carcinoma in situ (DCIS). Preoperative imaging was performed to assess the extent of disease. Magnetic resonance (MR) imaging of the breasts showed an area of clustered ring enhancement deep to the biopsy site, which was representative of residual DCIS. DCIS is a common noninvasive malignancy that manifests as a primary breast tumour or in association with other lesions. The radiological features of DCIS are discussed herein, with special attention to the clustered ring enhancement pattern on MR imaging.

Multiphase Contrast-Enhanced Magnetic Resonance Imaging Features of Bacillus Calmette-Guerin-Induced Granulomatous Prostatitis in Five Patients

OBJECTIVE: To evaluate the multiphase contrast-enhanced magnetic resonance (MR) imaging features of Bacillus Calmette-Guerin (BCG)-induced granulomatous prostatitis (GP). MATERIALS AND METHODS: Magnetic resonance images obtained from five patients with histopathologically proven BCG-induced GP were retrospectively analyzed for tumor location, size, signal intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI), apparent diffusion coefficient (ADC) value, and appearance on gadolinium-enhanced multiphase images. MR imaging findings were compared with histopathological findings. RESULTS: Bacillus Calmette-Guerin-induced GP (size range, 9-40 mm; mean, 21.2 mm) were identified in the peripheral zone in all patients. The T2WI showed lower signal intensity compared with the normal peripheral zone. The DWIs demonstrated high signal intensity and low ADC values (range, 0.44-0.68 x 10(-3) mm2/sec; mean, 0.56 x 10(-3) mm2/sec), which corresponded to GP. Gadolinium-enhanced multiphase MR imaging performed in five patients showed early and prolonged ring enhancement in all cases of GP. Granulomatous tissues with central caseation necrosis were identified histologically, which corresponded to ring enhancement and a central low intensity area on gadolinium-enhanced MR imaging. The findings on T2WI, DWI, and gadolinium-enhanced images became gradually obscured with time. CONCLUSION: Bacillus Calmette-Guerin-induced GP demonstrates early and prolonged ring enhancement on gadolinium-enhanced MR imaging which might be a key finding to differentiate it from prostate cancer.

MRI Findings of Intracranial Ring Enhanced Lesions / 医学研究杂志

Objective To study and analysis the MRI characteristics of common intracranial ring enhanced lesions.Methods MRI studies of 32 cases intracranial ring enhanced lesions were reviewed retrospectively,all cases were confirmed by surgery or pathology and anti-inflammatory treatment.Results Among 32 cases of Intracraninal ring enhaneed lesions included 12 glioblastomas,10 metastases,5 brain abscesses,2 craniophrayngiomas,1 tuberculosis granuloma,1 neurocysticercose,1 multiple sclerosis.On the whole,the malignant tumors displayed obviously heterogeneous thickness of the walls,especially the inner walls were uneven and coarse,While the non-tumor lesions demonstrated,regular shapers,smooth inner walls and even thickness of the walls.Conclusion Intracranial ring enhanced lesions has a specific MRI finding and can supply important diagnostic value.

Primary Central Nervous System Lymphoma in Organ Recipient

We report a case of primary central nervous system(CNS) lymphoma in an organ recipient. A 33-years-old man who underwent a renal transplantation 3years previously presented with headache and vomiting. In Brain computed tomography scans and magnetic resonance images showed multiple periventricular cystic rim enhancing masses. Pathologic diagnosis by stereotactic biopsy revealed malignant non-Hodgkins B-cell lymphoma. After pathologic confirmation, methotrexate chemotherapy and whole brain radiation therapy were done. Having experienced such a case, the authors strongly recommend to add primary CNS lymphoma as one of the differential diagnoses to brain abscess, metastatic brain tumor and glioblastoma multiforme in cases of multiple ring enhancing periventricular lesions of immunocompromised patient or organ recipient.

Utility of Magnetic Resonance Imaging in the Diagnosis of Breast Disease / 日本農村医学会雑誌

Magnetic resonance imaging (MRI) for diagnostic evaluation of the breast was performed in 61 patients who visted the Breast Clinic of our hospital and were suspected to have malignant tumors by physical examination and mammography between January and December 1999. In 58 patients undergoing histological diagnostic tests (8 with benignancy and 50 with breast cancer), we compared the imaging characteristics and the time-signal intensity curves acquired by dynamic imaging between benign and malignant lesions, and evaluated the usefulness of analyzing enhancement patterns on contrast MRI. Contrast MRI revealed strong tumor enhancement in all patients; the mean time required for the signal intensity to reach a peak was about 7 min in patients with benign tumors and about 2 min in those with breast cancer. Peripheral ring enhancement was observed in 40 of the 50 patients with breast cancer (80.0%), while such enhancement was not noted in any of the patients with benign tumors.<BR>Although diagnosis of breast disease by imaging has primarily relied on mammography and ultrasonography, the pattern of contrast enhancement on dynamic MRI also appears to be useful for determining the treatment method of breast tumors.

MR Imaging Study of Intracranial Ring Enhanced Lesions / 实用放射学杂志

Objective To study and compare the clinical and MR imaging characteristics of common intracranial ring enhanced lesions.Methods MR imaging studies of 65 intracranial ring enhanced lesions were reviewed retrospectively. The lesions included 17 glioblastomas, 17 metastasises, 12 brain abscesses, 8 acoustic neurinomas, 7 craniopharyngiomas, 3 neurocysticercosises, 1 malignant lymphoma. All cases were confirmed by surgery and pathology. Results The ring enhancement of tumors presented heterogenous thickness of thick walls and irregular forms. Among them, the highly malignant tumors appeared very obviously heterogeneous thickness of the walls, especially the inner walls were uneven and coarse. While the ring enhancement of the non-tumor lesions usually were of homogeneous thickness of the walls, regular shapes and smooth inner walls. Conclusion The different patterns of intracranial ring enhanced lesions on MR can supply important diagnostic information. Combining the patients' history, age, location and the information of magnetic resonance imaging, we may make correct diagnosis.