全数字化乳腺钼靶单独与联合磁共振诊断乳腺导管原位癌的准确度和成本效益分析

目的:比较全数字化乳腺钼靶单独与联合磁共振诊断乳腺导管原位癌(DCIS)的准确度和成本效益,为DCIS早期筛查方案的选择提供参考依据.方法:回顾性分析我院2014年8月至2018年8月经病理检查确诊的84例DCIS患者的临床资料,整理其术前全数字化乳腺钼靶、磁共振成像(MRI)表现,分析钼靶、MRI及钼靶联合MRI诊断...     

彩超与钼靶对乳腺导管内癌诊断的对比研究

目的 探讨彩超（CDUS）与数字化钼靶摄影（钼靶）对乳腺导管内癌（DCIS）的诊断价值。方法 回顾性分析73例患者79个病灶经病理确诊的DCIS术前CDUS及钼靶的影像资料,比较两者单独及联合诊断DCIS的价值。结果 经病理证实79个病灶中48个为DCIS。CDUS及钼靶诊断DCIS的敏感度分别为66.67%（32/48）和70.83%（34/48）,两者间差异无统计学意义（P>0.05）,特异性分别为90.32%和80.65%,阳性预测值分别为91.43%和85.00%,阴性预测值分别为63.64%和64.10%;两者联合诊断的敏感度为95.83%（46/48）,分别与其中一种诊断方法比较,差异有统计学意义(P<0.05)。结论 CDUS对DCIS病灶内部结构及周边导管结构紊乱检出优于钼靶,而钼靶能够较敏感地显示DCIS病灶内的微小钙化。两者联合可提高诊断DCIS的准确率。     

彩超联合钼靶在乳腺筛查中的价值

[目的]探讨彩超与钼靶联合应用在乳腺筛查中的价值。[方法]对11486名健康女性按照外科临床体检联合乳腺彩超及钼靶筛查模式,经活检或手术病理证实为良恶性肿瘤,进行分析、总结、评估。[结果]11486名健康女性中检出乳腺良恶性肿瘤111例,其中乳腺癌52例(4.53‰);自然人群团体筛查乳腺癌检出率为2.83‰(23/8132);自我选择人群个人筛查检出率为8.65‰(29/3354)。彩超漏诊率为8.06%,钼靶漏诊率为5.88%,两者联合漏诊率为3.80%。40～49岁为乳腺肿瘤的高发年龄段。[结论]临床外科体检联合乳腺彩超及钼靶的筛查模式是东方女性乳腺筛查较好的方法。     

乳腺钼靶联合磁共振成像检查在老年乳腺癌患者诊断中的价值

目的探讨乳腺钼靶联合磁共振成像(MRI)检查在老年乳腺癌患者诊断中的价值。方法选取2016年1月至2018年1月间上海中医药大学附属第七人民医院收治的82例老年乳腺肿瘤患者,均行乳腺钼靶检查、MRI检查及病理学检查,将病理学检查结果作为诊断金标准,比较两种检查方式单独检查和联合检查的诊断敏感度、特异性及准确性。结果 82例乳腺肿瘤患者中,42例(51. 2%)患者为良性乳腺肿瘤,40例(48. 8%)患者为乳腺癌。乳腺钼靶诊断钙化率显著高于MRI,差异有统计学意义(P <0. 05)。MRI诊断胸大肌浸润率显著高于乳腺钼靶,差异有统计学意义(P <0. 05)。乳腺钼靶联合MRI的诊断敏感度、特异性及准确性,均高于乳腺钼靶及MRI单独检查,差异均有统计学意义(均P <0. 05)。结论乳腺钼靶联合MRI检查在老年乳腺癌患者诊断中,有较高的诊断准确率,与病理检查结果符合率高,应在临床中广泛应用。     

彩色多普勒超声及数字化钼靶X影像在乳腺原位癌中的诊断价值

目的探讨乳腺导管原位癌(DCIS)采用彩色多普勒超声(CDUS)和数字化钼靶影像(MG)检查的临床诊断价值。方法选取2015年6月至2018年12月间中央军委政治工作部原机关门诊部收治的经手术病理确诊的103例DCIS患者,均行MG和CDUS检查,比较两种检查的影像学特征及两者对DCIS的诊断符合率。结果 MG显示,患者单纯钙化型66例(64. 1%),肿块伴钙化8例(7. 8%),单纯肿块11例(10. 7%),阴性18例(17. 5%),共检出74例钙化病灶。CDUS显示,患者单纯钙化型1例(1. 0%),肿块伴钙化16例(15. 5%),单纯肿块62例(60. 2%),阴性24例(23. 3%),共检出78例肿块。MG对DCIS的诊断符合率为82. 5%,CDUS诊断符合率为76. 7%,均低于两者联合的92. 2%,差异均有统计学意义(均P <0. 05)。结论 MG和CDUS对DCIS均有一定的诊断价值,但两者联合对DCIS的诊断符合率更高。     

常规超声、超声萤火虫技术与X线钼靶摄影对乳腺导管原位癌的诊断价值

目的 探讨常规超声、超声萤火虫技术与X线钼靶摄影对乳腺导管原位癌（DCIS）的诊断价值。方法选取120例疑似DCIS患者,术前均行常规二维超声、超声萤火虫技术及X线钼靶摄影检查,以病理诊断结果为金标准,评估常规二维超声、超声萤火虫技术、X线钼靶摄影单独及三者联合检查对DCIS的诊断价值。Kappa检验评估上述三种检查方法诊断DCIS的结果与病理诊断结果的一致性。结果 病理结果显示,120例患者均为单发病灶,DCIS 72例,恶性48例。常规二维超声、超声萤火虫技术、X线钼靶摄影联合检查诊断DCIS的结果与病理结果一致性极好（Kappa=0.810）,高于三者单独检查（Kappa=0.192、0.362、0.390）,且超声萤火虫技术、X线钼靶摄影诊断DCIS的结果与病理检查结果的一致性均高于常规二维超声。受试者工作特征（ROC）曲线显示,常规二维超声、超声萤火虫技术及X线钼靶摄影联合检查诊断DCIS的曲线下面积（AUC）为0.906(95%CI:0.844～0.969),分别高于单独常规二维超声、超声萤火虫技术及X线钼靶摄影的AUC,此时灵敏度、特异度、准确度分别为91.67%、89....     

MRI鉴别乳腺导管原位癌与其他导管内病变的价值

背景与目的：乳腺导管原位癌(ductal carcinoma in situ,DCIS)属于乳腺浸润性癌的前驱病变,是一类非全身性的导管内局部病变,与其他导管内病变在影像上存在相似之处。本研究旨在探讨乳腺MRI鉴别诊断DCIS与其他乳腺导管内病变的价值。方法：回顾性分析2011年7月—2012年2月于复旦大学附属肿瘤医院行乳腺MRI检查并经手术病理证实的DCIS患者24例、DCIS伴微浸润(breast ductal carcinoma in situ with microinvasion,DCIS-MI)9例、乳腺导管内乳头状瘤(breast intraductal papilloma,BIDP)20例临床资料。以DCIS为研究主体,分析3种病变MRI及动态增强表现。结果：DCIS与DCIS-MI的病灶强化形态、强化方式、时间-信号强度曲线(TIC)、病灶伪彩图像间差异均无统计学意义(P＞0.05),而DCIS与BIDP的病灶强化形态、强化方式、TIC、病灶伪彩图像间差异均有统计学意义(P＜0.05)。DCIS以导管样(8/24)及段样强化(6/24)为主、病灶伪彩图像为红色(22/24)、TIC以Ⅲ型(12/24)为主要特征性表现;BIDP以乳头后局灶性强化为主(13/20)、病灶伪彩图像为非红色(14/20)、TIC以Ⅱ型(11/20)为主要特征性表现。结论：MRI较难鉴别DCIS与DCIS-MI,但具有鉴别诊断DCIS与BIDP的价值。     

3.0TMR多期动态增强扫描在鉴别乳腺导管原位癌与乳腺腺病中的价值

目的:探讨3.0T MR动态增强扫描在鉴别乳腺导管原位癌和乳腺腺病中的价值。方法:研究纳入了经手术或穿刺活检证实的38例导管原位癌和40例乳腺腺病患者,对两组病变的MR多期动态增强表现进行回顾性对照分析,评价指标包括:强化形态、内部强化特点及时间-信号强度曲线,并对有统计学显著性差异的影像学征象的鉴别诊断价值进行分析。结果:导管样强化、节段样强化和肿块样强化多见于导管原位癌(P=0.04,0.04,0.02)。区域性强化和弥漫性强化多见于乳腺腺病(P=0.03,0.02)。点簇样强化及边缘强化多见于导管原位癌(P=0.02,0.03)。不均匀性强化多见于乳腺腺病(P=0.04)。速升缓降型曲线和速升平台型曲线多见于导管原位癌(P=0.03,0.02),持续缓升型和缓升平台型多见于腺病(P=0.03,0.04)。病变强化形态的鉴别诊断价值要高于内部强化特点和时间-信号强度曲线,其敏感度、特异度及准确度分别为69.2%、71.2%和70.4%。结论:3.0T MR动态增强扫描有助于鉴别导管原位癌和乳腺腺病,病变强化形态的鉴别诊断价值要高于内部强化特点和时间-信号强度曲线。     

超声及钼靶X线对乳腺导管内癌与乳腺浸润性导管癌的诊断价值

目的:探讨乳腺导管内癌（ductal caicinoma in situ,DCIS）与乳腺浸润性导管癌（invasive ductal carcinoma,IDC）的超声及钼靶X线影像特征差异。方法:回顾性分析160例患者（包括62例DCIS患者及98例IDC患者）的超声及钼靶X线资料。结果:161个乳腺病灶中,有62个DCIS病灶（DCIS组）及99个IDC病灶（IDC组）。超声对IDC组病灶的检出率明显高于DCIS组,两组间的检出率有统计学意义（P＜0.05）;两组间病灶超声表现中形状、边界、边缘特征及血流信号差异有统计学意义（P＜0.05）。钼靶X线在两组病灶检出率差异有统计学意义（P＜0.05）;两组间病灶钼靶X线表现形状及边缘特征的例数差异有统计学意义（P＜0.05）。对于DCIS组,超声及钼靶X线病灶的检出率差异有统计学意义（P＜0.05）;在病灶边缘及乳腺腺体内钙化检出率这些方面,两种方法有统计学意义（P＜0.05）。结论:乳腺钼靶X线对DCIS腺体内钙化灶诊断率较高,乳腺超声对DCIS病灶检出、病灶边缘特征显示具有诊断优势。     

磁共振成像诊断原发性肝癌评价

本文分析了１６５例原发性肝癌的磁共振成像（ＭＲＩ）价值。ＳＥ序列为Ｔ１加权成像（Ｔ１ＷＩ）；ＲＡＲＥ序列为Ｔ２加权成像（Ｔ２ＷＩ）。在Ｔ１ＷＩ上对肝脏结构显著显示清楚，而Ｔ２ＷＩ上主要对肝癌信号异常敏感性高，故对肝癌的范围、大小显示较为清楚。两处序列联合应用以及多层多平面横断加冠状切层可以精楚构画肝癌的部位、大小和范围。本研究提示，其敏感性ＭＲＩ比ＣＴ略高，但无统计学意义。ＭＲＩ优于Ｂ超，但不及Ｂ     

乳腺导管内癌数字化摄影与超声诊断的对比研究

目的探讨数字化摄影与超声检查对乳腺导管内癌的诊断价值。方法回顾性分析53例乳腺导管内癌病例,所有病例都接受了数字化摄影及超声检查。数字化摄影和超声诊断分为可能恶性、性质待定、可能良性和阴性。对照手术和病理组织学检查结果,比较数字化摄影和超声检查的价值。结果数字化摄影和超声分别诊断可能恶性36例和33例,性质待定4例和5例,可能良性7例和10例,阴性6例和5例。数字化摄影和超声诊断的准确性分别是67.9%(36/53)和62.3%(33/53)。数字化摄影结合超声诊断的准确性是88.7%(47/53)。结论数字化摄影和超声诊断可用于乳腺导管内癌的诊断,联合应用可提高诊断的准确性。     

胰腺癌血管受侵程度的彩超评估

 目的　评价彩色多普勒成像诊断胰腺癌周围血管受侵情况的准确性。方法　应用彩超对47例胰腺癌病人胰周血管受侵情况进行预测评估,并与外科结果进行了比较。结果　通过手术的47例病人受侵血管的诊断,彩超的敏感性、特异性和准确性分别是80%、91%和85%。阳性和阴性预测值分别是91%和80%。结论　彩超在评价胰腺癌血管受侵时有一定敏感性和高度特异性。当彩超检测到有血管包裹时,可以做出不可切除的肯定诊断,可以避免进一步的诊断过程。     

Magnetic Resonance Imaging (MRI) of Pseudosyrinxes

Six patients whose post-myelographic computed tomography (CT) showed syringomyelia but whose clinical findings were not consistent were evaluated with magnetic resonance imaging (MRI). In five of these patients no cavity was seen with MRI. A cavity was demonstrated in the sixth case but not in the region of abnormali ty on CT. MRI confirmed the clinical impression that intake of contrast into the cord did not represent a sryinx cavity. Possible causes are discussed. The term ‘pseudosyrinx’ is used for such a situation.     

Comparing Accuracy of Mammography and Magnetic Resonance Imaging for Residual Calcified Lesions in Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy

Background

Neoadjuvant systemic therapy (NST) is performed to increase the rate of breast-conserving surgery in advanced breast cancer patients. Although magnetic resonance imaging (MRI) is accurate in predicting residual cancer, if calcification remains, the issue of whether to perform the surgery on the basis of the residual tumor prediction range in mammography (MMG) or MRI has not yet been elucidated. This study aimed to estimate the accuracy of predicting residual tumor after NST for residual microcalcification on mammographic and enhancing lesion on MRI.

经直肠超声、超声造影与磁共振动态增强成像在前列腺癌诊断中临床价值比较

目的 研究比较经直肠超声（transrectal ultrasound, TRUS）、超声造影（contrast-enhanced ultrasonography, CEUS）与磁共振动态增强成像（dynamic contrast material-enhanced magnetic resonance imaging, DCE-MRI）在前列腺癌诊断中的临床价值。方法 回顾性分析临床疑诊前列腺癌并进一步行系统穿刺活检术的63例患者术前TRUS、CEUS、DCE-MRI的相关检查数据,结合病理组织学结果,对上述三种检查方法在前列腺癌诊断中的临床价值进行比较。结果 TRUS、CEUS、DCE-MRI对前列腺癌诊断的特异性分别为48.84%、74.42%和69.77%,敏感度分别为60%、65%和85%,诊断准确率分别为52.38%、71.43%、74.60%,TRUS、CEUS、DCE-MRI三种影像学检查方法对前列腺癌的诊断价值差异无统计学意义（P>0.05）;TRUS、CEUS、DCE-MRI的ROC曲线下面积比较结果分别为0.550、0.723、0.781,其中DCE-MRI的敏感度和准确率最高。结论 对疑诊前列腺癌患者的筛查中,CEUS、DCE-MRI较TRUS具有更高的准确率,而其中DCE-MRI的敏感度和准确率最高。     

磁共振成像对原发性肝癌立体定向放射治疗疗效的评价

目的探讨MRI对原发性肝癌三维立体定向放射治疗（3DCRT）疗效的临床价值。方法106例原发性肝癌患者3DCRT后行MRIT1WI、T2WI及动态增强检查,并进行临床分析。结果放疗后肝癌缩小缓慢,病灶在T1WI和T2WI上信号多变。存活肿瘤动态增强早期强化,静脉期和延迟期呈低信号;肿瘤坏死组织无强化。放射性肝损伤T1WI主要呈低信号,T2WI主要呈高信号,动态增强动脉期无强化或强化,静脉期及延迟期明显强化,强化持续时间长。结论MRI可判断放射治疗后原发性肝癌存活或坏死情况,能客观评价放疗的效果。     

MicroRNA-1277 Inhibits Proliferation and Migration of Hepatocellular Carcinoma HepG2 Cells by Targeting and Suppressing BMP4 Expression and Reflects the Significant Indicative Role in Hepatocellular Carcinoma Pathology and Diagnosis After Magnetic Resonance Imaging Assessment

Our study aimed to investigate the roles and possible regulatory mechanism of miR-1277 in the development of hepatocellular carcinoma (HCC). HCC patients were identified from patients who were diagnosed with focal liver lesions using magnetic resonance imaging (MRI). The expression levels of miR-1277 in the serum of HCC patients and HepG2 cells were measured. Then miR-1277 mimic, miR-1277 inhibitor, or scramble RNA was transfected into HepG2 cells. The effects of miR-1277 overexpression and suppression on HepG2 cell proliferation, migration, and invasion were then investigated. Additionally, the expression levels of epithelial– mesenchymal transition (EMT)-related markers, including E-cadherin, -catenin, and vimentin, were detected. Target prediction and luciferase reporter assay were performed to explore the potential target of miR-1277. miR-1277 was significantly downregulated in the serum of HCC patients and HepG2 cells. Suppression of miR-1277 promoted HepG2 cell proliferation, migration, and invasion, whereas overexpression of miR-1277 had opposite effects. In addition, after miR-1277 was suppressed, the expressions of E-cadherin and -catenin were significantly increased, while the expressions of vimentin were markedly decreased. Bone morphogenetic protein 4 (BMP4) was identified as the direct target of miR-1277. Knockdown of BMP4 reversed the effects of miR-1277 suppression on HepG2 cell migration and invasion, as well as the expressions of E-cadherin, -catenin, and vimentin. Our results indicate that downregulation of miR-1277 may promote the migration and invasion of HepG2 cells by targeting BMP4 to induce EMT. Combination of MRI and miR-1277 level will facilitate the diagnosis and treatment of HCC.     

Two Decades of Experience with Ductal Carcinoma in Situ of the Breast in the Cancer Institute of Tehran,Iran

Background: Breast cancer screening and higher quality mammography have resulted in an increase in thediagnosis of ductal carcinoma in situ worldwide. We compared the incidence and other factors in our cases ofductal carcinoma in situ between two recent decades. Materials and Methods: Medical records of cases of ductalcarcinoma in situ who had been admitted to the surgery wards of the Cancer Institute of Tehran, Iran wereevaluated from March 1993 to March 2003 as phase 1, and from April 2003 to April 2013 as phase 2. Results:Ratio of ductal carcinoma in situ to overall breast cancer was 1.27 and 3.93 in phases 1 and 2, respectively. Ratesof excisional or incisional biopsies versus core needle biopsies and clinically versus mammographically detectedcases as well as median size of tumors dropped between the 2 phases while a substantial rise in the numberof patients attending for screening was seen in this time period. Surgical treatments followed a trend frommodified radical mastectomy and axillary lymphatic dissection toward breast conserving surgery and sentinelnode dissection or no axillary intervention. Conclusions: Our study shows a considerable trend toward earlierdetection of breast cancer and evolution of treatment strategies toward standard less invasive surgery of DCISin Iran.