Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging

PURPOSE: To evaluate the value of diffusion-weighted imaging (DWI) in distinguishing between benign and malignant breast lesions. MATERIALS AND METHODS: Fifty-two female subjects (mean age = 58 years, age range = 25-75 years) with histopathologically proven breast lesions underwent DWI of the breasts with a single-shot echo-planar imaging (EPI) sequence using large b values. The computed mean apparent diffusion coefficients (ADCs) of the breast lesions and cell density were then correlated. RESULTS: The ADCs varied substantially between benign breast lesions ((1.57 +/- 0.23) x 10(-3) mm(2)/second) and malignant breast lesions ((0.97 +/- 0.20) x 10(-3) mm(2)/second). In addition, the mean ADCs of the breast lesions correlated well with tumor cellularity (P < 0.01, r = -0.542). CONCLUSION: The ADC would be an effective parameter in distinguishing between malignant and benign breast lesions. Further, tumor cellularity has a significant influence on the ADCs obtained in both benign and malignant breast tumors.     

Apparent diffusion coefficients of breast tumors: clinical application.

PURPOSE: To evaluate the usefulness of apparent diffusion coefficient (ADC) for the differential diagnosis of breast tumors and to determine the relation between ADC and tumor cellularity. MATERIALS AND METHODS: One hundred and thirty-six female patients (age range, 17-83 years; average age, 51.7 years) with 140 histologically proven breast tumors underwent diffusion-weighted magnetic resonance (MR) imaging (DWI) using the spin-echo echo-planar technique, and the ADCs of the tumors were calculated using 3 different b values, 0, 500, and 1000 s/mm(2). The diagnoses consisted of fibroadenoma (FA, n=16), invasive ductal carcinoma, not otherwise specified (IDC, n=117), medullary carcinoma (ME, n=3) and mucinous carcinoma (MU, n=4). Tumor cellularity was calculated from surgical specimens. The ADCs of breast tumors and cellularity were compared between different histological types by analysis of variance and Scheffe's post hoc test. The correlation between tumor cellularity and ADC was analyzed by Pearson correlation test. RESULTS: Significant differences were observed in ADCs between FA and all types of cancers (P<0.05) and between MU and other types of cancers (P<0.01) and in cellularity between FA and cancers except MU (P<0.01) and between MU and other types of cancers (P<0.01). There was an inverse correlation between ADC and tumor cellularity (P<0.01, r(2)=0.451). CONCLUSIONS: The ADC may potentially help in differentiating benign and malignant breast tumors. Tumor ADC correlates inversely with tumor cellularity.     

ADC值与乳腺浸润性导管癌恶性程度相关性分析

目的探讨雌激素受体阳性乳腺浸润性导管癌的表观扩散系数(ADC)值与肿瘤间质比、肿瘤大小及肿瘤分级的相关性。方法回顾性纳入术前行乳腺DWI和增强MRI扫描检查并经病理确诊为雌激素受体阳性乳腺浸润性导管癌的70例女性病人,年龄29~76岁,平均(49.58±6.81)岁。依据病理结果将病灶分为富间质型组和少间质型组,记录每个病灶的间质比并进行病理分级。在增强MRI影像上测量病灶最大直径,计算肿瘤ADC值。采用t检验、卡方检验和Mann-Whitney U检验分别比较2组间肿瘤最大直径、肿瘤分级及ADC值的差异。采用Spearman相关分析ADC值与肿瘤侵袭、恶性程度的相关性。结果富间质型组29例,少间质型组41例。2组间肿瘤分级的差异有统计学意义(P<0.05)。与少间质型组相比,富间质型组的最大直径更小,而ADC值更大(均P<0.05)。肿瘤最大直径、间质比及分级均与ADC值呈负相关(分别rs=-0.651,rs=-0.636,rs=-0.451,均P<0.05)。结论乳腺浸润性导管癌的ADC值与肿瘤直径、肿瘤间质比和肿瘤分级密切相关,能较好地反映肿瘤的恶性程度。     

In vivo diffusion-weighted MRI of the breast: potential for lesion characterization

PURPOSE: To investigate the potential of apparent diffusion coefficients (ADCs) in characterizing breast lesions in vivo.MATERIALS AND METHODS: Two diffusion-weighted (DW) sequences were implemented on a 1.5 Tesla scanner, with low b-value orthogonal and high b-value tetrahedral sensitized sequences. The orthogonal sequence was evaluated on 16 normal volunteers and 23 patients with known lesion types (six benign and 17 malignant). The tetrahedral sequence was evaluated on a smaller number of subjects: two normal, two malignant, and two benign.RESULTS: The mean value of the ADC of the malignant tumors was reduced compared to that of the benign lesions and normal tissue. This finding was related to the increased cellularity of the malignant lesions. The ADC values were elevated for all tissue types with the low b-value sequence as compared to the high b-value sequence, indicating contributions from perfusion effects at the low b-values.CONCLUSION: The study clearly shows that DW-MRI can help characterize breast lesions in vivo.     

11C-choline PET for the detection of bone and soft tissue tumours in comparison with FDG PET

We assessed and compared the usefulness of C-choline positron emission tomography (PET) with that of 2-[ F]fluoro-2-deoxy-D-glucose (FDG) PET for the differentiation between benign and malignant bone and soft tissue tumours. A total of 43 patients with 45 lesions were included. C-choline PET and FDG PET were performed from 5 and 40 min, respectively, after injection of 275-370 MBq tracer. PET data were evaluated by using the standardized uptake value (SUV) and were analysed according to the pathological data. C-choline uptake in malignancies was 4.9+/-2.1 (n=14), which was significantly higher than that in benign lesions (2.5+/-1.7, n=31) (P <0.0001). The sensitivity, specificity and accuracy of C-choline PET were 100%, 64.5% and 75.6%, respectively, when 2.59 of the SUV was used as the cut-off value. The FDG uptake in malignancies was 5.1+/-4.2 (n=14) and was also significantly larger than that in benign lesions 2.9+/-2.9 (n=31) (P<0.003). The sensitivity, specificity and accuracy of FDG PET were 85.7%, 41.9% and 55.6%, respectively (cut-off=1.83). The C-choline uptake in the lesions correlated with FDG uptake ( r=0.61, P<0.003). In receiver operating characteristic (ROC) analysis, the area under the ROC curve for C-choline PET (area=0.847) was higher than that for FDG PET (area=0.717). This study showed that C-choline PET was superior to FDG PET in differentiation between malignant and benign lesion in bone and soft tissue tumours. C-choline PET might be useful as a screening method for malignant bone and soft tissue tumours.     

磁共振信号强度在胸膜疾病中的诊断意义

目的评价磁共振信号强度在胸膜疾病中的诊断价值.方法48例不同胸膜疾病病人在Philips0.5T扫描仪下行MR检查.成像常规为T1WI、T2WI快速自旋回波扫描,所有病例均在病理证实结合临床资料下得出恶性或良性胸膜疾病的诊断.恶性疾病包括胸膜间皮瘤(n=10)、胸膜转移瘤(n=18),良性疾病包括结核性胸膜炎(n=9)、胸膜肥厚(n=7)、纤维胸(n=1)、脓胸(n=2)和胸膜炎性假瘤(n=1).将各种胸膜疾病T1WI、T2WI上绝对信号强度(ASI),病灶信号与肌肉信号的对比噪声比(CNR),信号强度比(SIR)分别进行测量或计算,判断它们在良、恶性胸膜疾病之间,胸膜间皮瘤与胸膜转移瘤之间是否存在差别.结果ASI在良、恶性胸膜疾病之间,胸膜间皮瘤与转移瘤之间均无显著差异,CNR在良、恶性胸膜疾病之间于T2WI上有差别(P＜0.01),而SIR在良、恶性胸膜疾病之间于T1WI、T2WI上均有极显著差异(P＜0.001),同时,还在胸膜间皮瘤与转移瘤之间于T2WI上存在差别(P＜0.05).结论磁共振信号强度在胸膜疾病鉴别诊断中有重要意义,其中SIR最具有诊断价值.MR信号强度在T2WI上比T1WI上更具有区分不同胸膜疾病的能力.     

盆部原发肿瘤CT表现特征及其解剖学基础

目的分析盆部原发肿瘤CT增强表现特征，探讨产生各种影像表现的病理学和解剖学基础。方法回顾性分析14例经病理学证实的盆部原发肿瘤CT增强表现，包括病灶大小、密度、边缘、强化特征，肿块所在的解剖部位及其与邻近组织器官和间隙的关系等。结果良性肿瘤3例，恶性肿瘤11例。肿块位于盆腹膜腔和腹膜外间隙各6例，盆腹膜腔和腹膜外间隙同时受累2例。CT增强表现为实质性8例，囊实性6例；均匀强化3例，不均匀强化11例。肿块周围脂肪间隙清晰和受侵犯各7例。4例病灶内出现钙化，其中良性畸胎瘤2例，恶性畸胎瘤和类癌各1例。结论CT增强扫描能准确判断盆部原发肿瘤的解剖位置及其与邻近解剖结构的毗邻关系，初步判断肿瘤的良恶性，对畸胎瘤能做出比较明确的定性诊断。     

Contribution of ultrasonography and fine-needle aspiration cytology to the differential diagnosis of palpable solid breast lesions.

PURPOSE: To define the role of ultrasonography (US) and fine-needle aspiration biopsy (FNAB) relative to mammography in differentiating between benign and malignant palpable solid breast lesions, and to assess the contribution of FNAB cytology to the delay between referral and the definitive diagnosis of breast cancer. MATERIAL AND METHODS: We retrospectively reviewed the mammograms and US images of 84 palpable breast lesions, 63 of them also blindly. The lesions were classified as benign, indeterminate or malignant by both modalities. The results were compared with histologic diagnoses. The cytologic reports of 57 lesions were reviewed and compared to the final diagnoses. The delay from referral until diagnosis was calculated for each case. RESULTS: Eighty-one of the 84 lesions (96%) were visible as a local abnormality at US. Fifty-two of the 53 cancers were seen as a tumor (n=51) or an architectural distortion (n=1). In the blinded analysis, the sensitivity of FNAB cytology was 92%, specificity 83%, and overall accuracy 88%. There were no false-negative malignancies in the three modalities combined. The delay until the date of the final diagnosis was shorter in the group with a cytologic diagnosis positive for malignancy. CONCLUSION: Malignancy is unlikely if the US, mammographic and cytologic findings of a palpable breast lesion are all benign. Active and critical use of these three modalities could cut down the number of surgical biopsies of benign breast lesions and provide prompt surgical treatment for malignant lesions.     

Quantitative apparent diffusion coefficients and T2 relaxation times in characterizing contrast enhancing brain tumors and regions of peritumoral edema

PURPOSE: To investigate the potential value and relationship of in vivo quantification of apparent diffusion coefficients (ADCs) and T2 relaxation times for characterizing brain tumor cellularity and tumor-related edema. MATERIALS AND METHODS: A total of 26 patients with newly diagnosed gliomas, meningiomas, or metastases underwent diffusion-weighted and six-echo multisection T2-preparation imaging. Regions of interest (ROIs) were drawn on conventional MR images to include tumor (as defined by contrast agent enhancement) and immediate and peripheral edema. Areas of necrosis were excluded. Median values of ADCs and T2 in the ROIs were calculated. RESULTS: ADCs for gliomas were similar to those for meningiomas or metastases in all regions. Tumor T2 values for gliomas (159.5+/-30.6 msec) were significantly higher than those for meningiomas or metastases (125.0+/-31.1 msec; P=0.005). Immediate-edema T2 values for meningiomas or metastases (226.0+/-44.1 msec) were significantly higher than those for gliomas (203.5+/-32.8 msec; P=0.033). Peripheral-edema T2 values for gliomas (219.5+/-41.9 msec) were similar to those for meningiomas or metastases (202.5+/-26.5 msec; P=0.377). Both immediate- and peritumoral-edema ADCs and T2 values were significantly higher than those in tumor for both tumor types. ADCs and T2 values from all regions correlated significantly for gliomas (r=0.95; P<0.0001) and for meningiomas or metastases (r=0.81; P<0.0001). CONCLUSION: The higher immediate-edema T2 values for nonglial tumors than for gliomas suggest tumor-related edema (vasogenic vs. infiltrated) can be further characterized by using T2 values. There were significant correlations between ADC and T2 values.     

肝脏局灶性病变MRI表现与病理学的相关性研究

肝脏局灶性病变的MRI信号强度受许多病理因素的影响。病变的组织学特征:细胞构成、血液供应、间质构成和肿瘤内的坏死或者出血等,都会使病变的T1及T2弛豫时间发生显著变化。细胞内的某些内容物:糖原、脂肪、黑色素、铁和铜,在决定MRI信号表现方面起着重要的作用。MRI与病理学之间联系的研究对于诊断局灶性病变非常有帮助。     

定量研究表观扩散系数与T2值在肝局灶性小病变中的应用价值

目的通过对表观扩散系数（ADC）与T2值的定量对比研究,探讨ADC值与T2值在肝脏局灶性小病变定性诊断中的价值. 资料与方法对临床发现有肝脏局灶性小病变患者73例（其中包括原发性肝细胞癌22例22个病灶,肝转移瘤16例26个病灶,肝海绵状血管瘤27例38个病灶,肝囊肿8例11个病灶）分别行磁共振扩散加权成像（DWI）和常规快速自旋回波（FSE）T2WI,然后测量计算各病变的ADC值及T2值,进行统计学分析,对比两种量化方法（ADC值和T2值）对肝脏良恶性病变的诊断准确性. 结果肝脏恶性病变的ADC值明显低于良性病变（P＜0.01）,其诊断准确性为93.8%;肝脏恶性病变的T2值也低于良性病变（P＜0.05）,但两者数值重叠较多,其诊断准确性为77.3%,有明显统计学差异（P＜0.05）. 结论利用ADC值在定性方面优于T2值,对肝脏局灶性小病变的诊断更具临床价值.     

Differentiation of benign and malignant tumors of the parotid gland: value of pulsed Doppler and color Doppler sonography

To establish criteria for the differentiation of benign and malignant tumors of the parotid gland using color Doppler sonography (CDS) and pulsed Doppler sonography (PDS) we examined 37 patients with parotid tumors by gray-scale ultrasound, CDS, and PDS. Tumor vascularization displayed by CDS was graded subjectively on a 4-point scale (0 = no vascularization, 3 = high vascularization). From the Doppler spectrum, the highest systolic peak flow velocity, the resistive index (RI), and the pulsatility index (PI) were calculated. There were 11 malignant and 26 benign tumors. Tumor vascularization by CDS was grade 0 or 1 in 88.5 % of benign lesions, whereas it was grade 2 or 3 in 82 % of malignant lesions (P < 0.0001). The highest systolic peak flow velocity was statistically significantly higher in malignant lesions than in benign lesions. Using a threshold systolic peak flow velocity of 25 cm/s, sensitivity was 72 % and specificity was 88 % for the detection of a malignant tumor. Evaluation of tumor vascularization by CDS and PDS cannot differentiate between benign and malignant parotid tumors with certainty. However, high vascularization and high systolic peak flow velocity in tumor vessels should raise the suspicion of malignancy, even if tumor morphology on gray-scale sonography indicates a benign lesion. Received 5 February 1998; Accepted 5 March 1998     

The benefit of SPECT when added to planar scintigraphy in patients with bone metastases in the spine.

PURPOSE: This study compared the efficiency of SPECT with planar bone scans in differentiating malignant from benign lesions and in detecting metastases to the spine. METHODS: Planar scintigraphy and SPECT were performed in 37 patients with low back pain without known malignancy and in 38 patients with confirmed malignancy. The type, location, and intensity of tracer accumulation were compared on the planar and SPECT scans. The malignant or benign nature of lesions was proved by radiologic methods, histologic findings, 6 month follow-up, or all of these. RESULTS: More metastases were detected by SPECT (SPECT, 58 of 64; planar, 42 of 64; P < 0.01). In three of seven patients with known malignancy who had a normal result of planar scan, only SPECT detected metastases. Fifty-nine metastases were radiologically mainly osteolytic, one was osteoblastic and four were mixed. Most lesions showed increased radioactivity (40 of 42 on planar scans vs. 45 of 58 on SPECT) and 2 of 42 (5%) vs. 12 of 58 (21%) were cold with marginally increased uptake. One of 58 metastases was a cold lesion seen on SPECT only. Lesions were more often malignant than benign when seen on SPECT in a pedicle (n = 5; malignant = 3, benign = 2), in the body and pedicle (n = 22; malignant = 14, benign = 8), within the vertebral body (n = 5; malignant = 4, benign = 1) and in the whole vertebra (n = 6; malignant = 4, benign = 2). The lesion to background ratio was higher on SPECT than on planar scans (SPECT, 2.26; planar scans, 1.86; P < 0.05 in malignant lesions). CONCLUSIONS: SPECT of the spine improved the diagnostic accuracy of bone scans when added to a planar scan in patients with known malignancy and clinical suspicion of spinal metastases when the planar scan was borderline abnormal. It helps in differentiating between benign and malignant lesions of the spine.     

US-guided percutaneous biopsy of small (< or = 1-cm) hepatic lesions

PURPOSE: To determine the accuracy of ultrasonography (US)-guided percutaneous biopsy in diagnosing malignant neoplasms for hepatic lesions 1 cm or smaller. MATERIALS AND METHODS: In this prospective study, 64 consecutive patients with 74 discrete focal hepatic lesions depicted at US were referred for liver biopsy to confirm the exact nature of the lesions. Mean lesion size was 0.84 cm +/- 0.13 (range, 0.5-1.0 cm). Biopsy was performed with an 18-gauge automated biopsy gun in 46 lesions (once [n = 37], twice [n = 7], three times [n = 2]) or a 22-gauge needle in 28 lesions (once [n = 23], twice [n = 4], three times [n = 1]). Measures were taken to ensure accurate and effective lesion sampling. The histologic diagnosis of malignant tumor and findings on follow-up US images of "benign" nodules for 15-39 months were the criterion standard. RESULTS: No complications occurred. All specimens obtained were sufficient for diagnosis. Histologic examination revealed various types of primary and secondary malignant tumors (n = 44), hemangioma (n = 5), cirrhosis (n = 13), focal fatty change (n = 8), focal fatty sparing (n = 2), and abscess (n = 2). The diagnostic discrimination of US-guided biopsy in diagnosing malignant tumors in these small lesions was sensitivity, 98%; specificity, 100%; positive predictive value, 100%; negative predictive value, 97%; and accuracy, 99%. CONCLUSION: Percutaneous biopsy under US control is highly accurate in providing a definitive histologic diagnosis of malignant neoplasms for small hepatic lesions if measures for ensuring precise and effective lesion sampling are taken.     

Diffusion-weighted single-shot echoplanar MR imaging for liver disease.

OBJECTIVE: The aims of this study were to determine apparent diffusion coefficients (ADCs) of the abdominal organs and liver lesions, to determine the effect of the magnitude of b values on the ADCs, and to determine whether measured ADCs of liver tumors help differentiate benign from malignant lesions. SUBJECTS AND METHODS: Six healthy volunteers and 126 patients were examined with diffusion-weighted single-shot echo-planar imaging using multiple b values (maximum, 846 sec/mm2). The ADCs of the liver, spleen, kidney, 49 malignant liver lesions (33 hepatocellular carcinomas, 15 metastatic liver tumors, and one cholangiocellular carcinoma), and 30 benign lesions (17 cysts, 12 hemangiomas, and one angiomyolipoma) were calculated. RESULTS: The ADCs of the abdominal organs and liver lesions showed smaller values when calculated with the greater maximum b values. The ADCs of the benign lesions calculated with all the b values of less than 850 sec/mm2 (2.49+/-1.39 x 10(-3) mm2/sec) were significantly (p = .0024) greater than those of the malignant lesions (1.01+/-0.38 x 10(-3) mm2/sec). When the maximum b value is 846 sec/mm2, use of a threshold ADC of 1.6 x 10(-3) mm2/sec would result in a sensitivity of 98% and a specificity of 80% for differentiation of malignant liver lesions from benign lesions. CONCLUSION. Measurement of ADC has good potential for characterizing liver lesions, but the calculated ADCs could be affected by the magnitude of the maximum b value.     

Incidental findings on sonography of the breast: clinical significance and diagnostic workup.

OBJECTIVE: The purpose of this study was to determine how often physician-performed high-resolution sonography can detect nonpalpable breast lesions not revealed by mammography. A sonographic classification scheme was tested for its accuracy in predicting malignancy of incidentally detected breast lesions. SUBJECTS AND METHODS: Six thousand one hundred thirteen asymptomatic women with breast density grades 2-4 and 687 patients with palpable or mammographically detected breast masses underwent sonography as an adjunct to mammography. All sonographically detected, clinically and mammographically occult breast lesions that were not simple cysts were prospectively classified into benign, indeterminate, or malignant categories. Diagnoses were confirmed by sonographically guided fine-needle aspiration or core needle biopsy. RESULTS: In 6113 asymptomatic women, 23 malignancies in 21 patients were detected with sonography only (prevalence, 0.31%). Five additional malignant lesions were found in patients with a malignant (n = 3) or a benign (n = 2) palpable or mammographically detected index lesion. The mean size of invasive malignancies detected only by sonography was 9.1 mm, which was not significantly different from the mean size of invasive cancers detected by mammography (p = .07). The sensitivity of the prospective sonographic classification for malignancy was 100%, and the specificity was 33.5%. CONCLUSION: The use of high-resolution sonography as an adjunct to mammography in women with dense breasts may lead to detection of a significant number of otherwise occult malignancies that are no different in size from nonpalpable mammographically detected lesions. Prospective classification of these lesions based on sonographic characteristics results in a significant reduction in number of unnecessary biopsies performed.     

星形细胞肿瘤ADC与细胞密度导航导引下的对照研究

目的:分析脑肿瘤的ADC及细胞密度,评价肿瘤组织ADC值与细胞密度的相关性及ADC值在评价肿瘤良恶性中的价值.材料和方法:10例脑肿瘤病例术前行DWI及导航序列扫描,在导航手术中切除肿瘤时,同时在导航仪图像上标记相应肿瘤组织的部位,标本送病理检查.采用NIH Image软件分析肿瘤组织细胞密度.在导航标记图的指导下测量相应部位的ADC值及T2信号强度,比较ADC值,T2信号强度与细胞密度的相关性及其在评价肿瘤良、恶性中的作用.结果:10例脑肿瘤中毛细胞型星形细胞瘤1例,星形细胞瘤3例,间变性星形细胞瘤1例,胶质母细胞瘤5例.ADC值与肿瘤细胞密度呈明显负相关,r=0.74,P＜0.001,T2信号强度与细胞密度仅有轻度相关,r=0.33,P＜0.05.WHO1～2级肿瘤的ADC值1.30±0.16×10-3mm2/s,T2信号强度1374±336;3～4级肿瘤ADC值0.90±0.16×10-3mm2/s,T2信号强度1110±171,良、恶性肿瘤各种参数之间两组比较均有显著性差异(P＜0.01).结论:ADC是评价星形细胞肿瘤细胞密度的一个有效手段.ADC值低的部位可能是肿瘤细胞密度高的部位,也就可能是恶性程度最高的部位,对于立体定向选择活检部位非常有效.良、恶性星形细胞肿瘤ADC值有明显差异,结合常规MRI,ADC值可用于推测脑肿瘤的良、恶性.     

Characterization of malignancy of adnexal lesions using ADC entropy: Comparison with mean ADC and qualitative DWI assessment

Purpose:

To establish the utility of apparent diffusion coefficient (ADC) entropy in discrimination of benign and malignant adnexal lesions, using histopathology as the reference standard, via comparison of the diagnostic performance of ADC entropy with mean ADC and with visual assessments of adnexal lesions on conventional and diffusion‐weighted sequences.

Materials and Methods:

In all, 37 adult female patients with an ovarian mass that was resected between June 2006 and January 2011 were included. Volume‐of‐interest was drawn to incorporate all lesion voxels on every slice that included the mass on the ADC map, from which whole‐lesion mean ADC and ADC entropy were calculated. Two independent radiologists also rated each lesion as benign or malignant based on visual assessment of all sequences. The Mann–Whitney test and logistic regression for correlated data were used to compare performance of mean ADC, ADC entropy, and the visual assessments.

Results:

No statistically significant difference was observed in mean ADC between benign and malignant adnexal lesions (P = 0.768). ADC entropy was significantly higher in malignant than in benign lesions (P = 0.009). Accuracy was significantly greater for ADC entropy than for mean ADC (0.018). ADC entropy and visual assessment by the less‐experienced reader showed similar accuracy (P ≥ 0.204). The more experienced reader's accuracy was significantly greater than that of all other assessments (P ≤ 0.039).

Conclusion:

ADC entropy showed significantly greater accuracy than the more traditional metric of mean ADC for distinguishing benign and malignant adnexal lesions. Although whole‐lesion ADC entropy provides a straightforward and objective measurement, its potential benefit decreases with greater reader experience. J. Magn. Reson. Imaging 2013;37:164–171. © 2012 Wiley Periodicals, Inc.     

低张水成像联合多模态MRI对十二指肠原发性肿瘤及肿瘤样病变的诊断价值

目的 探讨低张水成像联合多模态MRI在十二指肠原发性肿瘤及肿瘤样病变中的诊断价值.资料与方法 回顾性分析40例十二指肠原发性病变的低张水成像联合多模态MRI征象及病理结果,比较良性组与恶性组间各形态评价参数、表观扩散系数(ADC)值及增强时间-信号强度曲线(TIC)的差异.结果 良性组25例,恶性组15例.良性组形态较...     

Evaluation of strongly hyperintense area in breast lesions on fat-suppressed T2-weighted images correlated with histopathology

The purpose of this study was to correlate strongly hyperintense areas(SHI) in breast lesions on FS-T2WI with histopathology and to evaluate the usefulness of the distribution patterns of SHI in the differentiation of benign and malignant breast lesions. MR imaging with pathological correlation was available in 157 breast lesions of 153 patients. The distribution patterns of SHI were classified into seven types. SHI on FS-T2WI was identified in 36 of 157 breast lesions. The irregular and inhomogenous types corresponded to various histological features and were only seen in malignant lesions. The central type corresponded to central necrosis and was only seen in 2 solid-tubular carcinomas. The crescent type corresponded to peripheral fluid collection in the intracystic tumor. The septal type corresponded to fibromyxoid stroma with fibrous septations in the lesions except for one cavernous hemangioma, and was only seen in benign lesions. The smooth type corresponded to mucinous pool, fibromyxoid stroma, and ductal dilatation and did not contribute to differentiation between benign and malignant lesions only on FS-T2WI. SHI in breast lesions on FS-T2WI pathologically corresponded to mucin, fibromyxoid change, necrosis, and ductal dilatation. Evaluation of patterns of SHI is useful in differentiating between benign and malignant lesions.