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1.
Cavernomas fall within the group of angiographically occult lesions and may be found in up to 4 % of the population [1].
They may occur at any age, and with the advent of MRI incidental cavernomas are increasingly identified. The pathogenesis
is uncertain. Familial cases are well recognised with a reported prevalence of 10–15 % [2–3]. The incidence of new lesions
has been reported at 0.4 lesions per patient per year in cases with familial cavernomas [4]. Presumed cavernomas have been
documented following radiation for malignancy [5–6], and sterotactic cerebral biopsy [7]. There have been no previously documented
cases of de novo genesis of cavernomas following bacterial meningitis and subdural empyemas.
Received: 18 November 1999/Accepted: 11 February 2000 相似文献
2.
S. H. Heywang-Köbrunner A. Heinig U. Schaumlöffel P. Viehweg J. Buchmann D. Lampe R.-P. Spielmann 《European radiology》1999,9(8):1656-1665
The aim of this study was the realisation and clinical application of MR-guided vacuum biopsy for percutaneous excisional
and incisional biopsy of enhancing breast lesions. A breast biopsy system and procedure have been developed which allow precise
and safe access to breast lesions in any location and use of vacuum biopsy (VB) under MR guidance. Fifty-one patients with
55 MR-detected lesions were examined. Verification of these diagnoses included re-excision histology of all 14 malignancies
and for benign lesions retrospective correlation of histology and imaging, assessment of complete or partial removal of the
enhancing area directly after VB (40 of 40 lesions) and follow-up MRI (33 of 40 lesions), which in contrast to conventional
needle biopsy can be used as proof of representative removal. Fifty-four of 55 procedures (including 15 lesions ≤ 5 mm and
another 26 lesions of 5–10 mm size) were successful. One failure was caused by incorrect use of the VB gun. Vacuum biopsy
yielded 14 malignancies and 40 benign lesions. With the available verification techniques all diagnoses proved correct. Percutaneous
VB became possible under MR guidance. With minimal invasion it allowed increased certainty and accuracy even for very small
lesions.
Received: 17 August 1998; Revised: 15 January 1999; Accepted: 10 February 1999 相似文献
3.
Maria Teresa Farrés Thierry de Baere Christine Lagrange Luis Ramirez Phillipe Rougier Jean-Nicolas Munck Alain Roche 《Cardiovascular and interventional radiology》1998,21(5):399-403
Purpose: To determine the effects of percutaneous intratumoral chemotherapy with mitoxantrone (PIM) in the palliative treatment of
malignant liver lesions.
Methods: We treated 15 progressive lesions in nine patients in whom either previous therapy failed or serious complications developed
as a result. Seven lesions were metastatic and eight were due to foci of hepatocellular carcinoma. Under computed tomography
(CT) guidance, we percutaneously injected 10–20 mg of mitoxantrone mixed with 0.5 ml of contrast medium into the tumor, performing
one to three treatments at intervals of 1 month.
Results: There were no complications. The morphologic responses of the tumors after treatment were: minor response in one case, no
change in 11 cases, progressive disease in three cases. Mitoxantrone induced tumor necrosis with no viable cancer tissue in
eight of 11 biopsies. Recurrence was observed in nine of the treated lesions 2–9 months after treatment. New lesions were
observed in five of nine patients 1–9 months after treatment.
Conclusion: In patients with malignant liver lesions with no other therapeutic possibilities, minimally invasive intratumoral mitoxantrone
injection was carried out safely with good tumor delivery of chemotherapy, and tumor necrosis was demonstrated at biopsy.
We feel this approach warrants further investigation. 相似文献
4.
The purpose of this study was to determine the frequency of carcinoma at percutaneous directional vacuum-assisted removal
(DVAR) in women with imaging-histologic discordance during ultrasound (US)-guided automated core needle biopsy, and to determine
the role of DVAR in breast lesions with imaging-histologic discordance. A US-guided 14-gauge automated core needle biopsy
was performed on 837 consecutive lesions. Imaging-histologic discordance was prospectively considered in 33 of 634 benign
biopsies. DVAR was recommended in those lesions. Among the 33 lesions, 26 lesions that underwent subsequent DVAR or surgical
excision made up our study population. Medical records, imaging studies, and histologic findings were reviewed. Among the
26 lesions, 18 lesions underwent subsequent US–guided DVAR, with 8-gauge probes for 15 of the lesions, and 11-gauge for three
of the lesions. Two lesions were diagnosed as having carcinoma (2/18, 11.1% of upgrade rate; 3.1–32.8% CI). The remaining
eight lesions underwent subsequent surgical excision, and carcinoma was diagnosed in one case (12.5% of upgrade rate; 2.2–47.1%
CI). A US-guided DVAR of the breast mass with imaging-histologic discordance during US-guided 14-gauge automated core needle
biopsy is a valuable alternative to surgery as a means of obtaining a definitive histological diagnosis.
An erratum to this article can be found at 相似文献
5.
Nori J Cariti G Masi A Vivian A Di Lollo S Boeri C Vezzosi V Nori Bufalini F Bianchi S 《La Radiologia medica》2001,101(1-2):31-38
PURPOSE: We report our experience with large core biopsy (LCB: 14-Gauge needles) of questionable or suspicious breast lesions detected at mammography and/or US. All biopsies were performed under instrumental guidance. We also report on technique, costs, time, advantages and disadvantages of the method and, finally, give precise indications on when and why large core biopsy is needed. MATERIAL AND METHODS: From january 1996 to may 2000 we performed 1000 microhistologic biopsies on breast lesions at the Unità Integrata di Senologia, Azienda Ospedaliera Careggi, Florence; 650 (65%) were non palpable lesions. Large core needles were used (14-Gauge caliber). In the majority of cases (70%) we used US guidance, in the others a stereotactic guidance was employed. RESULTS: Microhistologic biopsy allowed accurate characterization in most cases. Inadequate samples were obtained in 15 cases. The false negative rate was 6%. Surgery was needed to characterize the lesion unquestionably in 13 cases only. CONCLUSION: In agreement with literature reports, our results confirm large core biopsy as an adequate alternative to surgical biopsy and, to some extent, to FNAC, thanks to its moderate invasiveness, low costs, short execution time, little patient discomfort and high sensitivity (93.98%) and specificity (99.7%). 相似文献
6.
Stattaus J Maderwald S Baba HA Gerken G Barkhausen J Forsting M Ladd ME 《European radiology》2008,18(12):2865-2873
The purpose of this study was to evaluate the diagnostic efficacy of magnetic resonance (MR)-guided biopsy of focal liver
lesions within a short, wide-bore 1.5-T MR system and to determine the duration and accuracy of needle placement using MR
fluoroscopy guidance in 25 patients. Accuracy of needle placement was evaluated in two orthogonal planes, and the out-of-plane
angle of needle deflection was measured. Needle positioning was characterised subjectively as centred, peripheral, or exterior
relative to the lesion. Exterior positioning was corrected by a step-by-step procedure. Surgical resection (n = 6), previous histologies (n = 8), or clinical/radiological follow-up (n = 11) served as the ‘gold standard’. The guidance needle could be placed successfully using MR fluoroscopy in 20 of 25 patients
(80%). Needle placement was rated as ‘centred’ in 11 and as ‘peripheral’ in nine patients. Median needle deflection was 2.6
degrees, with a median deviation of 3.4 mm. In five patients, the direct approach failed or was rated as ‘exterior’; therefore,
repositioning after needle stabilisation with a stainless-steel stylet was necessary. The diagnostic yield of all biopsies
was: sensitivity 95.5%, specificity 100.0% and accuracy 96.0%. In conclusion, MR-guided biopsies in a short, wide-bore MR
system yielded highly reliable biopsy results, and in most cases the direct approach with MR fluoroscopy guidance proved to
be fast and accurate. 相似文献
7.
Veltri A Garetto I Pagano E Tosetti I Sacchetto P Fava C 《Cardiovascular and interventional radiology》2009,32(1):76-85
The purpose of this study was to compare our experience with ultrasound (US)-guided percutaneous radiofrequency thermal ablation
(RFA) of renal tumors with results of CT-guided and MRI-guided series in the current literature. Of 90 consecutive renal tumors
treated with RFA in 71 patients, 87 lesions were ablated under US guidance. We performed a retrospective analysis of clinical
outcome and safety. Results were then compared to published case series where CT and MRI guidances were used exclusively.
In our series we had a major complication rate of 4.6%, whereas in CT- and MRI-based series it was 0–12% (mean, 2.2%) and
0–8.3% (mean, 4.1%), respectively. During follow-up (1–68 months; mean, 24 months) technical effectiveness was 89.7%, while
it was between 89.5% and 96% in CT-guided series and between 91.7% and 100% in MRI-guided series. The size of successfully
treated lesions (28 mm) was lower than that of partially-ablated lesions (36 mm; p = 0.004) and only central lesion location proved to be a negative prognostic factor (p = 0.009); in CT-guided series, positive prognostic factors were exophytic growth and size ≤3 cm. “Tumor-specific” 2-year
survival was 92% in our series, 90–96% in CT-guided series, and not reported in MRI-guided series. In conclusion, despite
common beliefs, US guidance in RFA of renal tumors is not less favorable than other guidance techniques. Thus the interventional
radiologist can choose his or her preferred technique taking into account personal experience and available equipment. 相似文献
8.
Caecilia S. Reiner Thomas H. Helbich Margaretha Rudas Lothar Ponhold Christopher C. Riedl Nina Kropf Michael H. Fuchsjäger 《European radiology》2009,19(12):2878-2885
The purpose of this study was to determine the value of galactography-guided, stereotactic, vacuum-assisted breast biopsy
(VABB) for the assessment of intraductal breast lesions and its potential as a therapeutic tool that could eliminate the need
for surgical excision. Eighteen patients (median age 64 years, range 37–80) with nipple discharge and galactography-verified
intraductal lesions underwent galactography-guided, stereotactic, 11-gauge VABB followed by surgery. Histopathology findings
from VABB and subsequent surgery were compared. Underestimation and false-negative rates were assessed. After VABB, histopathology
revealed invasive ductal carcinoma (IDC) in three (17%), ductal carcinoma in situ (DCIS) in six (33%), high-risk lesions in
six (33%) and benign lesions in three (17%) cases. After surgical biopsy, histopathology confirmed the previously established
diagnosis in 11 lesions (61%). The underestimation rate for high-risk lesions and DCIS was 50% (6/12). The false-negative
rate was 7% (1/14). Histopathology examination after surgery showed that not a single lesion had been completely removed at
VABB. Galactography-guided VABB is a feasible diagnostic tool. However, its value as a therapeutic procedure is limited because
of the high number of underestimated and missed lesions and because of the histopathological detection of lesions’ remnants
in every case. Surgical excision should be the therapeutic gold standard in cases of pathological nipple discharge and galactography
abnormalities. 相似文献
9.
Minimally invasive stereotaxic vacuum core breast biopsy 总被引:2,自引:0,他引:2
S. H. Heywang-Köbrunner U. Schaumlöffel P. Viehweg H. Höfer J. Buchmann D. Lampe 《European radiology》1998,8(3):377-385
The purpose of our study was the assessment of the diagnostic value of vacuum core biopsy, which promises high accuracy by
minimally invasive percutaneous excision of 1–2 cm3 of tissue. The materials used were a digital stereotaxic biopsy table (Fischer Imaging) and a Mammotome-gun (Biopsys). A
total of 236 patients with 261 predominantly indeterminate lesions (indeterminate: 230; suspicious: 26; malignant: 5) underwent
vacuum core biopsy (VCB). Verification was as follows: (a) demonstration of complete or partial removal of the lesion or replacement
of the lesion by a small hematoma by comparison of the pre- and post-VCB mammogram; (b) reexcision of 45 malignant and 6 borderline
lesions; (c) radiologic–histologic correlation; and (d) 6-month-follow-up mammograms in 129 cases. Two VCBs were not possible
because very fine microcalcifications could not be visualized. Two puncture errors occurred which, however, were immediately
recognized and VCB was repeated. Based on the above verification a 100 % accuracy was achieved. No relevant side effects occurred.
Except for 2 cases mammographically hardly any scarring was visible. Based on the excellent accuracy and excellent tolerance
of the procedure VCB appears to be the future method of choice for the workup of those indeterminate mammographically detected
lesions that up to now have still required surgical biopsy.
Received 5 September 1997; Accepted 12 September 1997 相似文献
10.
Thanos L Mylona S Galani P Kalioras V Pomoni M Batakis N 《Cardiovascular and interventional radiology》2006,29(2):264-269
Purpose To evaluate the efficacy and safety of CT-guided needle biopsy of brain lesions without a stereotactic device, and to determine
the best possible indications for this technique.
Methods From February 2001 to February 2004, 20 patients (12 men, 8 women; age 61–82 years) underwent CT-guided brain lesion biopsy.
The procedure started with a brain CT scan for lesion localization and for selection of the inlet for needle insertion. The
patient was then transported to the operating room where cranioanatrisis was performed. Subsequently, the biopsy was performed
under CT guidance using a 14G brain biopsy needle with a blind smooth end and lateral holes. At the end of the biopsy, the
field was checked for possible complications with a CT scan.
Results Histopathologic results were: brain tumor in 16 patients (80%), inflammatory process in 3 (15%), and no conclusive diagnosis
in 1 (5%). A repeat of the process was required in 2 patients. A minor complication of local hematoma was found in 1 patient
(5%). There were no deaths or other serious complications.
Conclusion CT-guided biopsy is a reliable method for histopathologic diagnosis of brain lesions in selected cases. It is a simple, fast,
effective, low-cost procedure with minimal complications, indicated especially for superficial and large tumors. 相似文献
11.
Schneider JP Dietrich J Lieberenz S Schmidt F Sorge O Trantakis C Seifert V Kellermann S Schober R Franke P 《European radiology》1999,9(2):230-236
The purpose of our study was to evaluate the feasibility and accuracy of brain biopsies performed within a vertically opened
MR system. We worked with the interventional 0.5-T MR “SIGNA SP” (General Electric Medical Systems, Milwaukee, Wis.) with
an integrated tracking device “Flashpoint Position Encoder” (Image Guided Technologies, USA). As a holding device for this
instrument we constructed a special frame. The whole system allows an exact adjustment of an optimum biopsy direction and
guidance of the biopsy in a non-stereotactic, interactive mode in near real-time. As biopsy tools we used MR-compatible aspiration
and specially made side-cut needles (Daum, Germany; E-Z-EM, USA). We performed a prospective diagnostic brain biopsy study
in 18 patients. Guidance of the needle was carried out using gradient-echo single-slice technique. The sample was taken after
controlling the exact position of the needle tip on spin-echo images. In 12 cases an exact neuropathological diagnosis was
possible. In 6 cases of negative biopsy (4 aspiration biopsies) the samples were not representative. Our results demonstrate
the feasibility of interactive MR-guided minimally invasive brain biopsies in an open MR system. The best results were achieved
using cut needles for biopsies of contrast-enhancing lesions visible on T1-weighted gradient-echo guidance sequence.
Received: 2 February 1998; Revision received: 13 July 1998; Accepted: 2 September 1998 相似文献
12.
Schick V Franzius C Beyna T Oei ML Schnekenburger J Weckesser M Domschke W Schober O Heindel W Pohle T Juergens KU 《European journal of nuclear medicine and molecular imaging》2008,35(10):1775-1785
Purpose This prospective single-centre phase II trial assessed the diagnostic impact of 18F-FDG PET–CT in the evaluation of solid pancreatic lesions (∅ ≥10 mm) compared to endosonography (EUS), endoscopic retrograde
cholangio-pancreatography (ERCP) with intraductal ultrasound (IDUS), abdominal ultrasound (US) and histopathological reference.
Methods Forty-six patients (32 men/14 women, ∅ 61.7 years) with suspected pancreatic neoplasms underwent PET–CT with contrast-enhanced
biphasic multi-detector CT of the upper abdomen followed by a diagnostic work-up with EUS, ERCP with IDUS and US within 3 weeks.
PET–CT data sets were analysed by two expert readers in a consensus reading. Histology from surgery, biopsy/fine-needle aspiration
and/or clinical follow-up ≥12 months served as standard of reference.
Results Twenty-seven pancreatic malignancies were histopathologically proven; 19 patients had benign diseases: 36/46 lesions (78%)
were detected in the head of the pancreas, 7/46 and 3/46 in the body and tail region, respectively. Sensitivity and specificity
of PET–CT were 89% and 74%, respectively; positive predictive value (PPV) and negative predictive value (NPV) were 83% and
82%, respectively. Sensitivity (81–89%), specificity (74–88%), PPV (83–90%) and NPV (77–82%) achieved by EUS, ERCP and US
were not significantly different. PET analysis revealed significantly higher maximum mean standardised uptake values (SUVmax 6.5 ± 4.6) in patients with pancreatic malignancy (benign lesions: SUVmax 4.2 ± 1.5; p < 0.05). PET–CT revealed cervical lymphonodal metastasis from occult bronchogenic carcinoma and a tubular colon adenoma with
intermediate dysplasia on polypectomy, respectively.
Conclusions
18F-FDG PET–CT achieves a comparably high diagnostic impact evaluating small solid pancreatic lesions versus conventional reference
imaging modalities. Additional clinical diagnoses are derived from concomitant whole-body PET–CT imaging.
Verena Schick and Christiane Franzius contributed equally to this work. 相似文献
13.
C. M. Pacella G. Bizzarri V. Anelli D. Valle R. Fabbrini A. Bianchini P. Fenderico Z. Rossi 《European radiology》1998,8(1):30-35
The aim of this work was to study the vascularization of hepatocellular carcinoma (HCC) by means of dynamic CT and to demonstrate
the existence of optimal temporal windows for visualization of HCC in order to develop new protocols for helical CT of the
liver. We studied, by means of dynamic CT, 42 histologically proved HCCs in 30 patients after injecting contrast medium (100
ml, 3 ml/s). We performed a time–density analysis of the aorta, liver, portal vein, spleen and lesion. We identified three
temporal curves of attenuation of the neoplastic tissue. Curve 1 was three-phasic: hyperattenuation, isoattenuation and hypoattenuation;
curve 2 was two-phasic: hyperattenuation and isoattenuation; curve 3 was two-phasic: isoattenuation and hypoattenuation. Thirty-two
lesions were homogeneous (curve 1 in 22 cases, 68.7 %; curve 2 in 7 cases, 21.8 %; curve 3 in 3 cases, 9.4 %), whereas 10
lesions were non-homogeneous. Two optimal temporal windows were identified: the first, with predominantly hyperattenuating
lesions (range 29–65 s, 90.4 % sensitivity); the second, with predominantly hypoattenuating lesions (range 132.1–360 s, 76.1
%). There is an interposed time range of reduced visualization (range 62–127 s, 54.7 %) in which lesions are isoattenuating.
Combined CT study during the first and second temporal windows improves the detection of HCCs especially for homogeneous and
small lesions. The intermediate isoattenuation time range does not increase lesion detection rate.
Received: 22 March 1996; Revision received 3 September 1996; Accepted 21 March 1997 相似文献
14.
T. G. Gleeson J. Moriarty C. P. Shortt J. P. Gleeson P. Fitzpatrick B. Byrne J. McHugh M. O’Connell P. O’Gorman S. J. Eustace 《Skeletal radiology》2009,38(3):225-236
Aim The aim of the study is to assess the feasibility of whole-body low-dose computed tomography (WBLDCT) in the diagnosis and
staging of multiple myeloma and compare to skeletal survey (SS), using bone marrow biopsy and whole-body magnetic resonance
imaging (WBMRI; where available) as gold standard.
Materials and methods Patients referred over an 18-month period for investigation of suspected multiple myeloma or restaging of myeloma were randomized
to undergo one of two WBLDCT protocols using high kVp, low mAs technique (140 kVp, 14 mAs; or 140 kVp, 25 mAs). Recent WBMRI
scans were reviewed in 23 cases. Each imaging modality was assessed by two radiologists in consensus and scored from 0–3 (0 = normal,
1 = 1–4 lesions, 2 = 5–20 lesions, 3 ≥ 20 lesions/diffuse disease) in ten anatomical areas. Overall stage of disease, image
quality score, and the degree of confidence of diagnosis were recorded. Diagnostic accuracy of skeletal survey and WBLDCT
were determined using a gold standard of bone marrow biopsy and distribution of disease was compared to WBMRI.
Results Thirty-nine patients were evaluated. WBLDCT identified more osteolytic lesions than skeletal survey with a greater degree
of diagnostic confidence and led to restaging in 18 instances (16 upstaged, two downstaged). In those with recent WBMRI, distribution
of disease on WBLDCT showed superior correlation with WBMRI when compared with SS. Overall reader impression of stage on WBLDCT
showed significant correlation with WBMRI (κ = 0.454, p < 0.05). WBLDCT provided complementary information to WBMRI in nine patients with normal marrow signal following treatment
response, but which were shown to have diffuse residual cortical abnormalities on CT.
Conclusion WBLDCT at effective doses lower than previously reported, is superior to SS at detecting osteolytic lesions and at determining
overall stage of multiple myeloma, and provides complementary information to WBMRI. 相似文献
15.
G. J. Wengert F. Pipan J. Almohanna H. Bickel S. Polanec P. Kapetas P. Clauser K. Pinker T. H. Helbich P. A. T. Baltzer 《European radiology》2020,30(3):1451-1459
To investigate whether the application of the Kaiser score for breast magnetic resonance imaging (MRI) might downgrade breast lesions that present as mammographic calcifications and avoid unnecessary breast biopsies This IRB-approved, retrospective, cross-sectional, single-center study included 167 consecutive patients with suspicious mammographic calcifications and histopathologically verified results. These patients underwent a pre-interventional breast MRI exam for further diagnostic assessment before vacuum-assisted stereotactic-guided biopsy (95 malignant and 72 benign lesions). Two breast radiologists with different levels of experience independently read all examinations using the Kaiser score, a machine learning–derived clinical decision-making tool that provides probabilities of malignancy by a formalized combination of diagnostic criteria. Diagnostic performance was assessed by receiver operating characteristics (ROC) analysis and inter-reader agreement by the calculation of Cohen’s kappa coefficients. Application of the Kaiser score revealed a large area under the ROC curve (0.859–0.889). Rule-out criteria, with high sensitivity, were applied to mass and non-mass lesions alike. The rate of potentially avoidable breast biopsies ranged between 58.3 and 65.3%, with the lowest rate observed with the least experienced reader. Applying the Kaiser score to breast MRI allows stratifying the risk of breast cancer in lesions that present as suspicious calcifications on mammography and may thus avoid unnecessary breast biopsies.
• The Kaiser score is a helpful clinical decision tool for distinguishing malignant from benign breast lesions that present as calcifications on mammography.
• Application of the Kaiser score may obviate 58.3–65.3% of unnecessary stereotactic biopsies of suspicious calcifications.
• High Kaiser scores predict breast cancer with high specificity, aiding clinical decision-making with regard to re-biopsy in case of negative results. 相似文献
16.
目的探讨在CT导引下半自动活检枪经皮软组织活检术对病变的诊断价值及临床应用,提高CT导向经皮穿刺活检技术的水平。方法采用ToshibaXvision螺旋CT机和SiemensEmotion6型多层螺旋CT扫描仪及半自动活检枪(16G~22G),对100例胸、腹部占位性病变患者行CT导向经皮穿刺活检术。病灶直径1.5cm~11.7cm。结果99例患者穿刺成功,穿刺成功率为99%,其中,93例取得满意的细胞和组织学材料。本组患者均未发生与操作相关的严重并发症。结论CT导向经皮半自动活检枪穿刺活捡成功率和确诊率高,创伤小,并发症少,是胸、腹部占位性病变诊断及鉴别诊断的一种操作简便、安全可靠的检查方法。 相似文献
17.
Strobel K Exner UE Stumpe KD Hany TF Bode B Mende K Veit-Haibach P von Schulthess GK Hodler J 《European journal of nuclear medicine and molecular imaging》2008,35(11):2000-2008
Objective To evaluate the value of a dedicated interpretation of the CT images in the differential diagnosis of benign vs. malignant
primary bone lesions with 18fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT).
Materials and methods In 50 consecutive patients (21 women, 29 men, mean age 36.9, age range 11–72) with suspected primary bone neoplasm conventional
radiographs and 18F-FDG-PET/CT were performed. Differentiation of benign and malignant lesions was separately performed on
conventional radiographs, PET alone (PET), and PET/CT with specific evaluation of the CT part. Histology served as the standard
of reference in 46 cases, clinical, and imaging follow-up in four cases.
Results According to the standard of reference, conventional 17 lesions were benign and 33 malignant. Sensitivity, specificity, and
accuracy in assessment of malignancy was 85%, 65% and 78% for conventional radiographs, 85%, 35% and 68% for PET alone and
91%, 77% and 86% for combined PET/CT. Median SUVmax was 3.5 for benign lesions (range 1.6–8.0) and 5.7 (range 0.8–41.7) for malignant lesions.
In eight patients with bone lesions with high FDG-uptake (SUVmax ≥ 2.5) dedicated CT interpretation led to the correct diagnosis of a benign lesion (three fibrous dysplasias, two osteomyelitis,
one aneurysmatic bone cyst, one fibrous cortical defect, 1 phosphaturic mesenchymal tumor). In four patients with lesions
with low FDG-uptake (SUVmax < 2.5) dedicated CT interpretation led to the correct diagnosis of a malignant lesion (three chondrosarcomas and one leiomyosarcoma).
Combined PET/CT was significantly more accurate in the differentiation of benign and malignant lesions than PET alone (p = .039).
There was no significant difference between PET/CT and conventional radiographs (p = .625).
Conclusion Dedicated interpretation of the CT part significantly improved the performance of FDG-PET/CT in differentiation of benign
and malignant primary bone lesions compared to PET alone. PET/CT more commonly differentiated benign from malignant primary
bone lesions compared with conventional radiographs, but this difference was not significant. 相似文献
18.
Warapat Virayavanich Ravi Singh Richard J. O’Donnell Andrew E. Horvai Robert E. Goldsby Thomas M. Link 《Skeletal radiology》2010,39(11):1145-1149
Osteoid osteoma occurs most commonly in children, adolescents, and young adults between the ages of 5 and 30 years. In the
preschool age group, it is quite uncommon, accounting for only 3–8% of all osteoid osteoma cases. We report a case of osteoid
osteoma in a 7-month-old infant, who presented with decreased use of the right lower extremity due to pain. Magnetic resonance
imaging (MRI) showed an atypical appearance. A biopsy of the lesion, with histopathological examination, confirmed the diagnosis
of osteoid osteoma. Radiofrequency ablation (RFA) of the nidus under computed tomography (CT) guidance was performed. The
patient developed a recurrence after 3 months, which was treated with a second RFA. On subsequent follow-up, the infant did
not show signs of pain after 1 month. In summary, this case report shows that osteoid osteoma can present in early infancy
and can be successfully treated with RFA at this age, however, recurrence after the procedure can occur and close follow-up
is recommended. 相似文献
19.
20.
The purpose of this study was to retrospectively evaluate the use of US elastography in the differentiation of mammographically
detected suspicious microcalcifications, using histology as the reference standard. Between May 2006 and April 2007, real-time
US elasticity images were obtained in 77 patients (age range, 24–67 years; mean, 46 years) with 77 mammographically detected
areas of microcalcifications (42 benign and 35 malignant lesions) prior to needle biopsy. Two experienced radiologists reviewed
cine clips of elasticity and B-mode images and assigned an elasticity score of 1 to 3 in consensus, based on the degree of
strain in the hypoechoic lesion without information of mammography and histology. For the elasticity score, the mean ± standard
deviation was 1.5 ± 0.7 for benign and 2.7 ± 0.7 for malignant lesions (P < 0.001). When a cutoff point between elasticity scores of 1 and 2 was used, US elastography showed 97% (34/35) sensitivity,
62% (26/42) specificity, 68% (34/50) PPV, and 96% (26/27) NPV with an Az value of 0.852 (0.753–0.923, 95% confidence interval)
in the differentiation of benign and malignant microcalcifications. Our results suggest that US elastography has the potential
to differentiate benign and malignant lesions associated with microcalcifications detected at screening mammography. 相似文献