作用于乳腺组织的近红外脉冲光

背景:传统诊断乳腺疾病的方法大多具有对人体有损伤和价格昂贵的弊端。近年来,通过研究乳腺组织的光学特性来诊断乳腺疾病的方法,因其具有安全无损、经济实惠的优点而受到一定的关注。目的:分析近红外脉冲光作用于人体乳腺的组织光学特性的临床应用价值。方法:利用760nm和850nm两种波长的近红外脉冲光穿透乳腺组织,对接收到的透射光进行两种波长的功率谱和互相关分析。结果与结论:近红外脉冲光分别作用于健康乳腺和患病乳腺存在差别,正常、良性和恶性乳腺的互相关系数依次降低。初步临床研究表明:近红外脉冲光作用乳腺组织的光学特性研究有利于乳腺疾病的鉴别诊断和临床应用。     

近红外线扫描诊断1098例乳腺疾病的分析

近红外扫描是一种无损伤性检查乳腺疾病的一种方法。我国于1988年开始相继推广并应用于临床，我科自1997年至今应用近红外扫描检查乳腺疾病1098例，结合临床取得了满意的诊断效果。现报道如下。     

电脑红外线扫描诊断乳腺疾病2386例分析

目的：探讨各种乳腺疾病及乳腺癌应用电脑红外线扫描诊断乳腺疾病的临床价值。方法：应用电脑红外线扫描仪诊断各类乳腺疾病2 386例,结合临床进行分析。结果：红外线诊断乳腺癌36例,诊断符合率90%。可疑乳腺癌5例,不符合2例,乳腺良性病变符合率93.2%。结论：红外线扫描具有无创性、快捷、科学性强等特点,在临床上具有一定的诊断价值。     

光学成像技术在乳腺病变诊断中的应用及进展

光学成像技术是近年来发展的一种新的功能成像技术。该技术通过对组织血红蛋白浓度及血氧饱和度的测量,反映肿块内部代谢状况,从而为乳腺病变的诊断和鉴别诊断提供重要信息,具有很高的临床应用价值。本文就光学成像技术的发展及其在乳腺病变诊断中的应用与最新研究进展进行综述。     

131例乳腺疾病超声诊断与病理结果对照分析

目的：对131例乳腺疾病超声诊断与病理结果对照分析,探讨乳腺疾病的发病情况及超声在乳腺疾病诊断中的准确率和临床应用价值。方法：对131例以乳腺疾病就诊而行超声检查并全部行手术病理患者的超声诊断与病理结果进行回顾性对照分析。结果：乳腺疾病主要为乳腺腺病、乳腺纤维腺瘤、乳腺癌、乳腺炎等,超声诊断与其病理结果对照诊断准确率为94.1%。结论：超声检查作为一种方便简洁、无痛无创、安全的诊断手段越来越得到了临床医师和患者的认可,是诊断乳腺疾病最好的手段之一。     

近红外线热图像诊断乳腺疾病的研究

目的：乳腺疾病是影响女性健康的常见病，我们探讨红外线扫描仪在乳腺疾病，特别是在乳腺良恶性肿瘤诊断中的作用。方法：应用红外线扫描仪在暗室中将探头贴干患者乳房下后方，对其四个象限行扇形透照，摄取图像，进行电子计算机程序处理分析。部分病例同病理诊断进行对照研究。结果：近红外乳腺扫描诊断与病理确诊的病例相比较，符合率为：乳腺增生性疾病为93．58％（306／327）；纤维腺瘤为95．45％（441／462）；乳腺癌为94．86％（240／253）例；副乳腺100％（25／25）；乳腺囊性疾病为75％（3／4）；乳腺内出血及淤血为80茗（4／5）。结论：红外线乳腺扫描是一种经济、简便、成像清晰、准确度较高的无损伤检查方法，有较高的诊断符合率，是检查筛选乳腺疾病及乳腺良、恶性肿瘤的重要方法。     

近红外线扫描用于乳腺疾病诊断（附4840例分析）

目的：探讨近红外线扫描在乳腺疾病诊断中的方法及乳腺疾病的发病分析。方法：应用近红外线扫描检查门诊病人和乳腺普查4840例。结果：用近红外线扫描能识别出不同的乳腺疾病，鉴别乳腺良、恶性肿瘤。结果：近红外线扫描是诊断乳腺疾病的较为可靠的方法，在临床诊断及乳腺普查中有较高的应用价值。     

6种影像学技术在致密型乳腺诊断中的应用

乳腺癌居于我国女性恶性肿瘤发病的首位,严重危害女性健康。致密型乳腺是乳腺癌的风险因素之一。在致密型乳腺中早期发现、早期诊断乳腺癌非常重要。乳腺X线摄影因受组织重叠、致密腺体遮盖等影响,对致密型乳腺病变检出存在一定局限性。近年来不断发展的功能成像技术,如动态对比增强磁共振成像、弥散加权成像、正电子发射计算机断层显像、乳腺专用伽马成像,通过反映肿瘤血流动力和代谢的变化从而提高致密型乳腺病变的检出。同时,新兴的光声成像技术能提供生物组织结构信息与功能信息,在深层组织中空间分辨率高,其在乳腺疾病中的应用逐渐受到重视。本文对数字乳腺三维断层摄影、超声检查、MRI检查、PET/CT检查、BSGI检查及光声成像等几种影像学检查方法在致密型乳腺诊断中的应用进行综述,为临床医生对致密型乳腺疾病的早期诊断提供帮助。      

光声成像技术及其在乳腺肿瘤诊断中的应用

光声成像作为一种新兴的生物医学成像技术,以光声效应为成像基础,兼备光学高对比度、超声高穿透度的优点,同时具有光谱信息获取能力,可进行功能成像,具有良好的临床应用前景。乳腺肿瘤是目前光声成像技术临床应用最广泛的领域,本文综述光声成像技术特点及其在乳腺肿瘤的临床应用现状,并对未来应用前景进行展望。     

癌基因在乳腺良、恶性疾病组织中的表达及其意义

目的:探讨癌基因c-erbB-2、P53、PCNA蛋白的表达在乳腺良、恶性疾病诊断中的意义。方法:应用免疫组织化学方法检测c-erbB-2、P53、PCNA蛋白在1180例乳腺癌、292例乳腺良性疾病组织中的表达,分析其与各临床病理因素的关系。结果:c-erbB-2、P53、PCNA蛋白在乳腺良、恶性疾病组织中表达有显著差异,在乳腺非典型增生、乳导管乳头状瘤或瘤病的表达高于其他良性病变而低于乳腺癌。在乳腺癌中的表达与临床分期、组织学分级、腋淋巴结状态及病理类型等预后指标密切相关。结论:癌基因c-erbB-2、P53、PCNA蛋白可作为乳腺良、恶性疾病的鉴别诊断及判断潜在恶性倾向的乳腺良性病变的参考指标,同时也是判断乳腺癌预后的重要依据。     

基因转染血管内皮生长因子促进损伤咬肌的血管生成

背景：放射线对恶性肿瘤的复发起预防作用,但长期大剂量放射治疗会对周围正常组织造成损害,因此如何预防及治疗放射线对周围组织的损伤一直是关注的焦点.目的：观察放射治疗对大鼠咬肌组织的损伤情况及基因转染血管内皮生长因子对咬肌组织血管生成的影响.方法：用直线加速器对 Wistar 大鼠咬肌组织进行照射,总剂量40 Gy ,照射后将重组质粒pcDNA4-HisMax-C/血管内皮生长因子165及空质粒分别转染至大鼠咬肌区.于治疗结束后2周行转化生长因子β1、血管内皮生长因子蛋白免疫组化染色,检测两种蛋白的表达情况,同时在光镜下观察大鼠咬肌组织的病理变化.结果与结论：放疗损伤组大鼠转化生长因子β1的表达水平明显高于正常对照组,重组质粒基因转染后咬肌组织血管内皮生长因子蛋白表达水平明显高于放疗损伤组、空质粒转染组及正常对照组.提示转化生长因子β1可以促进损伤组织的修复;血管内皮生长因子基因转染可促进放射治疗后咬肌组织血管的生成,从而促进放疗损伤的修复.     

Wistar大鼠的咬肌放射损伤模型

背景：构建稳定可靠的咬肌放射损伤模型对颌面部肿瘤放疗的相关研究有重要意义。目的：以放射剂量40Gy照射后Wistar大鼠咬肌构建大鼠咬肌放射损伤模型。方法：成年Wistar大鼠20只,随机分成正常对照组和放射损伤组。放射损伤组采用直线加速器照射大鼠咬肌区累积40Gy制造咬肌放射损伤。在28d后,在光镜及电镜下观察咬肌放射区病理改变,RT-PCR检测转化生长因子B1的基因表达。结果与结论：40Gy照射后28d大鼠咬肌区出现结构受损、血管密度减低（P〈0．01）等放射损伤表现,同时引起转化生长因子β1的基因表达升高（P〈0．001）等机体被动修复表现。结果证实Wistar大鼠咬肌区直线加速器40Gy照射可以作为咬肌放射损伤模型。     

Sonographic Findings of Accessory Breast Tissue in Axilla and Related Diseases

Accessory breast tissue results from failed regression of primitive mammary tissue and is most often located in the axilla. Accessory breast tissue itself is normal and should not be misdiagnosed as an abnormality. Both benign and malignant diseases that occur in the normal breast can also develop in accessory breast tissue in the axilla. In this pictorial essay, we show sonographic findings of normal accessory breast tissue in the axilla and various lesions that occur in accessory axillary breast tissue, along with other imaging findings and pathologic features.     

Sonographic appearance of a carcinoma developed in ectopic axillary breast tissue

Primary breast cancer of ectopic axillary breast tissue is almost never diagnosed preoperatively. When not accompanied by nipple-areolar complex, the mass is often believed to be a lipoma, an enlarged lymph node, or a skin lesion such as a sebaceous cyst or hydradenitis suppurativa. When an axillary mass is found, a percutaneous needle biopsy is mandatory to rule out the diagnosis of cancer in ectopic breast tissue. We describe the sonographic findings of a case of ductal carcinoma in axillary ectopic breast tissue.     

自动乳腺全容积扫描在乳腺疾病诊断中的应用进展

各种影像检查技术在乳腺疾病诊断中正发挥着越来越重要的作用,自动乳腺全容积扫描(ABVS)问世于2009年,并已经初步应用于临床.目前关于ABVS的主要研究成果表明,其克服了二维灰阶超声对操作者的依赖,扫描覆盖金乳,对冠状面的显示有利于更全面、准确地检出病灶.不过,ABVS也存在一些局限性,如在其采集的图像上发现病变时,无法进行彩色多普勒血流成像、弹性成像等辅助鉴别诊断.当然,ABVS作为一种先进的乳腺超声诊断技术,还有很多方面有待于进一步探究,如图像算法的精炼及工作站效率的提高,应用ABVS诊断乳腺占位性病变统一诊断标准的制定,在外周血管病变、浅表软组织等方面的拓展应用等.     

Characterization of light penetration in rat tissues

OBJECTIVE: The goal of this study is to determine the optical properties of different rat tissues with respect to spatial intensity variation and light distribution. We are interested mainly in the wavelength of 630 nm. Nevertheless, for liver tissue we have used 514 nm and 670 nm as well. BACKGROUND DATA: In the past, many articles have been written about the interaction of lasers with rat tissues. However, the technique of imaging the light distribution allows us to obtain the spatial scattering as well as an effective attenuation coefficient for the light intensity. METHODS: Slices of different rat tissues were placed between two microscope slide mounts (spaced by 3 mm). A laser beam was irradiated on the sandwiched tissue. A CCD camera placed on the side, orthogonal to the beam path, recorded the intensity distribution of the scattered light. Analysis of this spatial intensity profile allowed determining the variation of the intensity as the light penetrates the tissue. RESULTS: We have found that abdominal wall fat presents the lowest exponential decay when compared with liver, muscle, and kidney. The obtained values provided good data about the light distribution in those tissues when irradiated with a nondiffuse laser beam. For all tissues, we observed a spherical light distribution and exponential decay. Cirrhotic liver shows much stronger decay than healthy liver. These results are useful for several applications of laser for biostimulation a phototherapy.     

Combined Photoacoustic and Acoustic Imaging of Human Breast Specimens in the Mammographic Geometry

A photoacoustic volume imaging (PAVI) system was designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3-D ultrasound (AUS). The goal of the work described here was to validate the design and evaluate its performance in human breast tissues for non-invasive imaging of deeply positioned structures covering such geometry. The good penetration of near-infrared light and high receiving sensitivity of a broad-bandwidth, 572-element, 2-D polyvinylidene fluoride (PVDF) array at a low center frequency of 1 MHz were used with 20 channel simultaneous acquisition. Pseudo-lesions filled with dilute blood were imaged in three human breast specimens at various depths up to 49 mm. With near-infrared light illumination and 256-sample averaging, the extrapolated maximum depth in imaging a 2.4-mm blood-rich lesion with a 3-dB contrast-to-noise ratio in a compressed breast was 54 mm. Three-dimensional photoacoustic volume image stacks of the breasts were co-registered with 3-D ultrasound image stacks, suggesting for the first time that PAVI, based on the intrinsic tissue contrast, can visualize tissue interfaces other than those with blood, including the inner skin surface and connective tissue sheets. With the designed system, PAVI revealed satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides in the mammographic geometry with mild compression.     

Mammotome微创旋切术治疗乳腺肿瘤680例分析

目的：探讨超声引导下Mammotome微创旋切系统对乳腺病灶进行微创切除的治疗价值。方法：在超声图像监控下,利用Mammotome系统对680例1 900个乳腺肿块进行切除及病理检查,并记录术后随访情况。对其进行回顾性分析,评价其在乳腺微创外科的应用价值。结果：680例1 900个乳腺肿块被准确地完全切除,切除组织量大,足够用于病理诊断,术后病理学诊断1例为恶性,其余均为良性。1175个肿块为纤维腺瘤,661个肿块为纤维腺病,19个肿块为导管内乳头状瘤,42个肿块为囊肿及囊性增生,2个肿块为管状腺瘤,1个肿块为乳腺小管癌。术后每3-6个月定期接受复查,术后切口小而隐蔽,瘢痕不明显,乳腺外形及皮肤感觉正常,超声未发现病灶残留,复发。结论：Mammotome技术对乳腺病灶可进行完整切除,是准确、有效、安全、美观、值得推广的乳腺微创技术。     

Multiphoton excitation imaging via an actively mode-locked tunable fiber-cavity SOA laser around 800 nm

In this study, an active mode-locked tunable pulsed laser (AML-TPL) is proposed to excite picosecond pulsed light with a rapid wavelength tunability of approximately 800 nm for multiphoton microscopy. The AML-TPL is schematically based on a fiber-cavity semiconductor optical amplifier (SOA) configuration to implement a robust and align-free pulsed light source with a duration of 1.6 ps, a repetition rate of 27.9271 MHz, and average output power of over 600 mW. A custom-built multiphoton imaging system was also built to demonstrate the imaging performance of the proposed AML-TPL by comparing with the commercial Ti:Sapphire femtosecond laser. Two-photon excited fluorescence images were successfully acquired using a human breast cancer cell line (MDA-MB-231) stained with acridine orange.     

Ectopic glandular breast tissue in a lactating young woman

Background

Ectopic breast tissue is a rare occurrence in pregnant women and should not be confused with abscess or other causes. Ectopic breast tissue is present at birth but often only diagnosed after puberty, pregnancy, or lactation.

Objective

Misdiagnosis is of concern due to the fact that ectopic breast tissue may undergo pathological changes with increased risk of malignancy. Therefore, it is vital for emergency physicians to be able to recognize this process and ensure proper follow-up care.

Case Report

We present a case of ectopic breast tissue in a 19-year-old primigravida.

Conclusion

Surgical removal for the purpose of prophylaxis of malignant changes is not currently recommended. Definitive diagnosis is established by fine-needle aspiration and excisional biopsy.