共查询到20条相似文献,搜索用时 15 毫秒
1.
Amr Farouk Ibrahim Moustafa Eman Faker Kamal Maher M. Hassan Mona Sakr Mohammed Mohammed Mohammed Gomaa 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):259-264
Objective
To evaluate the additive value of Contrast Enhanced Spectral Mammography (CESM) in the preoperative assessment of malignant lesions in dense breast parenchyma regarding multiplicity.Material and methods
The study included 160 women having heterogeneous dense breast parenchyma (ACR c and d) with suspicious lesions identified on sono mammography examination. All patients performed contrast enhanced spectral mammography to confirm or exclude lesion multiplicity. The number of lesions was calculated in the contrast high energy subtraction images with the reference standard being histopathological analysis.Results
Adding CESM to sono-mammography the accuracy in identifying multiple malignant lesion increased from 81.8% accuracy of sono-mammography up to 100% accuracy after adding CESM.Conclusion
Contrast enhanced spectral mammogram showed an added value in the preoperative assessment of breast masses increasing the accuracy of detection of lesions and multiplicity (multifocality and multi-centricity). 相似文献2.
Noha Abd ElShafy ElSaid Hebatallah G.M. Mahmoud Asmaa Salama Marwa Nabil Eman D. ElDesouky 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):519-527
Objective
To evaluate the accuracy of CESM technique in predicting the final pathological response and residual tumor size post NAC in LABC.Patients and methods
This study was prospectively carried on 21 female patients diagnosed with stage II and III breast cancer. CESM was done at the end of last cycle of chemotherapy and before definitive surgery.Results
The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), false negative and false positive of the CESM were assessed by comparing the enhancement of the residual lesions and their size post neoadjuvant chemotherapy (NAC) with the final pathological response and residual tumor size in the MD Anderson system. The specificity of the CESM in predicting the tumor response to NAC in this initial study is 91%, sensitivity was 40% and the NPV and PPV were 80% and 62.5% respectively. The sensitivity of this technique for complete response detection was 100% with a specificity 83% and lowered sensitivity in detecting chemoresistant tumors (33.3%).Conclusion
CESM is an emerging easy technique that can predict the final pathologic tumor response after NAC especially complete response acting as a good negative technique. 相似文献3.
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Maha Helal Manal F. Abu Samra Mohammed A. Ibraheem Asmaa Salama Ebtesam Esmail Hassan Nour El-Huda Hassan 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):741-750
Aim
Assess accuracy of contrast enhanced spectral mammography (CESM) versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation.Patients and methods
Thirty female patients with 35 breast lesions diagnosed by conventional imaging as BI-RADS 3 and 4, presented to Women’s Imaging Unit of Radiology Department between January and December 2015, age ranged from 23 to 70 years. All patients underwent conventional mammography and ultrasound then CESM.Results
Patients divided into two groups, benign and malignant lesions group according to histological analysis. Mammography results that malignant lesions detected in 18/35 (51.4%) while benign lesions 17/35 (48.6%). Ultrasound revealed 27/35 (77.1%) lesions were malignant and 8/35 (22.9%) lesions benign. But CESM, revealed 25/35 (71.4%) lesions were malignant & 10/35 (28.6%) lesions benign. Among 7 patients with multifocal/ multi-centric histologically proven malignant lesions, all detected by CESM 7/7 cases (100%) versus 2/7 cases (28.6%) and 6/7 cases (85.7%) detected by mammography and ultrasound respectively. Based on, CESM had 95.2% sensitivity and 82.9% diagnostic accuracy.Conclusion
CESM has better diagnostic accuracy than mammography alone and mammography plus ultrasound. CESM has 82.9% diagnostic accuracy in comparison to 51.4% for mammography and 77.1% for ultrasound. 相似文献6.
Yasmin Mounir Tohamey Omar Sherif Omar 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):1190-1197
Objective
Assess the efficacy of using different imaging modalities aiming at proper characterization of benign and malignant inflammatory breast disorders.Methods
A prospective study included 34 patients presenting with clinical signs of mastitis. The patients underwent imaging according to clinical status (mammography, ultrasound and Magnetic resonance imaging) and the signs encountered in each modality were tested for their efficiency to discriminate benign from malignant inflammatory breast disorders.Results
Benign mastitis was finally diagnosed in 23 cases (67.4%) while 11 patients as malignant including inflammatory breast carcinoma.Mammogram was done in 22/34 cases (64.7%). The final diagnostic indices of mammography showed sensitivity 33.3%, specificity 61.54%, PPV 37.5%, NPV 57.14% and efficacy 50%.Ultrasound was done for all cases (34/34, 100%) with sensitivity 58.33%, specificity 72.73%, PPV 53.85%, NPV 76.19% and efficacy 67.6%.MRI was done for all cases (34/34, 100%) with sensitivity 91.67%, specificity 100%, PPV 100%, NPV of 95.65% and efficacy 97.1%.Conclusion
Diagnostic approach to inflammatory disorders includes multi-imaging modalities. Each modality plays a specific role in diagnosis with the highest specificity encountered on MRI evaluation followed by ultrasound and limited specificity on mammographic evaluation. It is essential to discriminate benign from malignant etiologies as there are major differences in their prognosis, and treatment options. 相似文献7.
Objectives
To demonstrate the value of diffusion-weighted imaging (DWI) in the characterisation of mastitis lesions.Methods
Sixty-one non-puerperal patients with pathologically confirmed single benign mastitis lesions underwent preoperative examinations with conventional MRI and axial DWI. Patients were categorised into three groups: (1) periductal mastitis (PDM), (2) granulomatous lobular mastitis (GLM), and (3) infectious abscess (IAB). Apparent diffusion coefficient (ADC) values of each lesion were recorded. A one-way ANOVA with logistic analysis was performed to compare ADC values and other parameters. Discriminative abilities of DWI modalities were compared using the area under the receiver operating characteristic curve (AUC). P < 0.05 was considered statistically significant.Results
ADC values differed significantly among the three groups (P = 0.003) as well as between PDM and IAB and between PDM and GLM. The distribution of non-mass enhancement on dynamic contrast-enhanced (DCE) MRI differed significantly among the three groups (P = 0.03) but not between any two groups specifically. There were no differences in lesion location, patient age, T2WI or DWI signal intensity, enhancement type, non-mass internal enhancement, or mass enhancement characteristics among the three groups.Conclusions
ADC values and the distribution of non-mass enhancement are valuable in classifying mastitis subtypes.Key points
? Mastitis subtypes exhibit different characteristics on DWI and DCE MRI. ? ADC values are helpful in isolating PDM from other mastitis lesions. ? Distribution of non-mass enhancement also has value in comparing mastitis subtypes.8.
Objectives
To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) to digital mammography (MG) and magnetic resonance imaging (MRI) in a prospective two-centre, multi-reader study.Methods
One hundred seventy-eight women (mean age 53 years) with invasive breast cancer and/or DCIS were included after ethics board approval. MG, CESM and CESM?+?MG were evaluated by three blinded radiologists based on amended ACR BI-RADS criteria. MRI was assessed by another group of three readers. Receiver-operating characteristic (ROC) curves were compared. Size measurements for the 70 lesions detected by all readers in each modality were correlated with pathology.Results
Reading results for 604 lesions were available (273 malignant, 4 high-risk, 327 benign). The area under the ROC curve was significantly larger for CESM alone (0.84) and CESM?+?MG (0.83) compared to MG (0.76) (largest advantage in dense breasts) while it was not significantly different from MRI (0.85). Pearson correlation coefficients for size comparison were 0.61 for MG, 0.69 for CESM, 0.70 for CESM?+?MG and 0.79 for MRI.Conclusions
This study showed that CESM, alone and in combination with MG, is as accurate as MRI but is superior to MG for lesion detection. Patients with dense breasts benefitted most from CESM with the smallest additional dose compared to MG.Key Points
? CESM has comparable diagnostic performance (ROC-AUC) to MRI for breast cancer diagnostics.? CESM in combination with MG does not improve diagnostic performance.? CESM has lower sensitivity but higher specificity than MRI.? Sensitivity differences are more pronounced in dense and not significant in non-dense breasts.? CESM and MRI are significantly superior to MG, particularly in dense breasts.9.
Faten Fawzy Mohamed Hosam Nabil Almassry Mohamed Hamdy Sharaf 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):991-997
Background
MS plaques display different pattern of enhancement with variable clinical course. The purpose is to assess the role of ADC value as a predictive for MS histologic changes with different enhancing pattern and its correlation with disease activity.Patients and methods
This prospective study included 28 chronic MS patients with 75 lesions, subjected for magnetic resonance imaging and ADC value measurement of the plaques and normally appearing white matter (NAWM) to be correlated with that of normal white matter (NWM) in 20 healthy controls.Results
T1-Hypointense and confluent lesions had statistical significant higher mean ADC value relative to the isointense and discrete lesions. Statistical significance difference was detected between mean ADC value of homogeneously enhancing lesions (HELs) and ring enhancing lesions (RELs) and between HELs and non-enhancing lesions (NELs), but no difference between NELs and RELs. Statistical significance difference was detected between ADC of NAWM relative to NWM of healthy controls.Conclusion
ADC value predicts histological changes in MS lesions. Pattern of enhancement doesn't correlate with neurologic deficits but ADC value is more valuable in assessing the disease activity. 相似文献10.
Hyo Soon Lim Cherie M. Kuzmiak Seo In Jeong You Ri Choi Jin Woong Kim Ji Shin Lee Min Ho Park 《Korean journal of radiology》2013,14(4):551-558
Objective
To analyze the magnetic resonance (MR) imaging findings of invasive micropapillary carcinoma of the breast.Materials and Methods
MR images were retrospectively evaluated in 14 patients (age range: 37-67, mean age: 49 years) with pathologically confirmed invasive micropapillary carcinoma of the breast. The enhancement type (mass/non-mass), shape, margin, contrast enhancement, and time-intensity curve pattern on the dynamic study were correlated with the histopathologic features. Associated findings, such as edema, nipple change, skin change and enlarged axillary lymph nodes were also studied.Results
The most common features of the masses were irregular shape (12 of 14 patients, 85.8%) and irregular or spiculated margin (11 of 14 patients, 78.7%). The contrast enhancement was heterogeneous in 11 patients (78.7%), rim enhancement in 2 cases (14.2%), and homogeneous in one patient (7.1%). The predominant kinetic pattern was rapid increase (14 of 14, 100%) in the initial phase and washout (11 of 14, 78.7%) in the delayed phase. Associated non-mass like enhancement was shown in 4 patients, representing ductal carcinoma in situ. MR imaging helped detect additional sites of cancer other than the index lesion in 3 patients (21.4%). Enlarged axillary lymphadenopathy was identified in 7 of the 14 patients (50%).Conclusion
Invasive micropapillary carcinoma appears as a mass with an irregular shape, irregular or spiculated margin and heterogeneous enhancement on MR imaging. Though these findings are not specific and are also observed with other breast malignancies, invasive micropapillary carcinoma frequently showed multiple lesions, accompanying non-mass enhancement and axillary lymph node enlargement. 相似文献11.
Doaa M. Emara Amr M. El Abd Amr M. El Fatatry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):181-189
Aim of the work
The aim of this study was to assess the rule of delayed T1 post contrast sequence in detection of active lesions in multiple sclerosis patients by comparing the early and delayed T1 post contrast images.Materials
This was a prospective study and included 30 known multiple sclerosis patients with clinically suspected activity referred form neurology department to radiology department for MRI examination.Methods
All patients were subjected to the followings: –?Conventional routine MRI of the brain using 1.5?T machine. –?T1 delayed post contrast sequence (about 10?min after contrast injection).Results
The included MS cases showed 162 lesions of variable distribution as 113 lesions were supratentorial while 49 lesions were infratentorial. Among 162 lesions in the current cases 58 lesions showed post contrast enhancement while the remaining 104 lesions were non enhancing. From the total of enhancing lesions (58), 16 lesions showed early enhancement while 42 lesions showed delayed enhancement.Conclusion
Delayed T1 post contrast is an important sequence for detection of active MS plaques as it increases the sensitivity of MRI. 相似文献12.
Objectives
Contrast-enhanced spectral mammography (CESM) is a promising problem-solving tool in women referred from a breast cancer screening program. We aimed to study the validity of preliminary results of CESM using a larger panel of radiologists with different levels of CESM experience.Methods
All women referred from the Dutch breast cancer screening program were eligible for CESM. 199 consecutive cases were viewed by ten radiologists. Four had extensive CESM experience, three had no CESM experience but were experienced breast radiologists, and three were residents. All readers provided a BI-RADS score for the low-energy CESM images first, after which the score could be adjusted when viewing the entire CESM exam. BI-RADS 1-3 were considered benign and BI-RADS 4-5 malignant. With this cutoff, we calculated sensitivity, specificity and area under the ROC curve.Results
CESM increased diagnostic accuracy in all readers. The performance for all readers using CESM was: sensitivity 96.9 % (+3.9 %), specificity 69.7 % (+33.8 %) and area under the ROC curve 0.833 (+0.188).Conclusion
CESM is superior to conventional mammography, with excellent problem-solving capabilities in women referred from the breast cancer screening program. Previous results were confirmed even in a larger panel of readers with varying CESM experience.Key Points
? CESM is consistently superior to conventional mammography ? CESM increases diagnostic accuracy regardless of a reader’s experience ? CESM is an excellent problem-solving tool in recalls from screening programs13.
Enass M. Khattab Mai E.M. Khamis Ayman F. Ahmed 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):519-528
Objective
This study aimed to assess the diagnostic value of a combined imaging protocol of diffusion-weighted MRI, apparent diffusion coefficient (ADC) values, and MR spectroscopy(MRS) in discriminating benign and malignant breast lesions.Patients and methods
twenty-six female patients complaining from breast lesions were included in this study. Diffusion weighted images, apparent diffusion coefficients value, and magnetic resonance spectroscopy were obtained to all patients.Results
Combined ADC value and MRS in discriminating benign breast lesions from malignant tumors were false-positive in 3 patients , true-positive in 14 patients, false-negative in 1 patient and true-negative in 8 patients with specificity of 72.7%, sensitivity of 93.3%, NPV of 88.9%, PPV of 82.4% and accuracy of 84.6%.Conclusion
A great advantage of ADC value is the significant difference between benign and malignant lesions, because of this it plays an important role in characterization of breast lesions. MRS is the only in vivo technique which can detect tissue metabolites. In our study combined MRS with ADC value increased sensitivity in detecting lesions, while the specificity remained at lower level than that of the ADC value alone. 相似文献14.
Objective
To retrospectively evaluate characteristics of and determine appropriate follow-up recommendations for BI-RADS category 3 lesions detected in preoperative MRI of breast cancer patients.Methods
BI-RADS category 3 assessments were identified from the breast MRI database for 5,110 consecutive breast cancer patients who had undergone preoperative MRI and surgery. Patient and lesion characteristics, malignancy rate, and interval between lesion detection and cancer diagnosis were analysed. Histopathological results or imaging at or after 2-year follow-up were used as reference standards.Results
Of the 626 lesions, morphological features included a single focus in 26.5% (n?=?166), multiple foci in 47.1% (n?=?295), mass in 21.7% (n?=?136) and non-mass enhancement in 4.6% (n?=?29). Cancer was found in 0.8% (5/626) at a median interval of 50 months (range, 29–66 months). Malignancy rate according to morphological feature was: 1.8% (3/166) in a single focus, 0.7% (1/136) in mass and 3.4% (1/29) in non-mass enhancement. All detected cancers were stage 0 or IA.Conclusions
Annual follow-up might be adequate for BI-RADS category 3 lesions detected at preoperative MRI because of the 0.8% (5/626) malignancy rate, long interval between lesion detection and cancer diagnosis, and early stage of diagnosed cancers.Key Points
? BI-RADS category 3 lesions on preoperative MRI had 0.8% malignancy rate. ? All cancer diagnoses from BI-RADS 3 occurred after 24-month follow-up. ? Annual follow-up might be adequate for BI-RADS 3 detected on preoperative MRI.15.
Mai E.M. Khamis Ahmed M. Alaa El-deen Ahmad Abdel Azim Ismail 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):1149-1157
Objective
To detect the diagnostic efficiency of sono elastographic strain ratio in discriminating malignant from benign solid breast masses and compare it with the sono elastographic elasticity score method.Patients and methods
This study included 120 histopathologically diagnosed solid breast masses from 120 females (mean age 38.2?years). Elastography score and strain ratio (SR) were performed for each mass. Receiver operating characteristic (ROC) curve was plotted for both methods.Results
The benign lesions had significant lower SR (mean 2.12?±?1.72) than that of malignant lesions (mean 6.91?±?3.96). The AUC from ROC curve was 0.98 for elasticity score and 0.99 for SR. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the elasticity score in the diagnosis of solid breast masses were 100%, 88%, 83.3%, 100% and 92.5% respectively, and of the strain ratio were 93.3%, 97.3%, 95.5%, 96.1% and 95.8% respectively (when cutoff value 3.77 was used). There is no statistically significant difference found between both methods.Conclusion
SR has high diagnostic performance in differentiating malignant from benign solid breast masses, however there is no statistically significant difference between SR and elasticity score. 相似文献16.
Wen-Chiung Lin Hsian-He Hsu Chao-Shiang Li Jyh-Cherng Yu Giu-Cheng Hsu Cheng-Ping Yu Tsun-Hou Chang Guo-Shu Huang 《Korean journal of radiology》2011,12(1):44-51
Objective
To evaluate the nature and imaging appearance of incidental enhancing breast lesions detected on a routine contrast-enhanced chest CT.Materials and Methods
Twenty-three patients with incidental enhancing breast lesions on contrast-enhanced chest CT were retrospectively reviewed. The breast lesions were reviewed by unenhanced and enhanced CT, and evaluated by observing the shapes, margins, enhancement patterns and backgrounds of breast lesions. A histopathologic diagnosis or long-term follow-up served as reference standard.Results
Sixteen (70%) patients had malignant breast lesions and seven (30%) had benign lesions. In 10 patients, the breast lesions were exclusively detected on contrast-enhanced CT. Using unenhanced CT, breast lesions with fibroglandular backgrounds were prone to be obscured (p < 0.001). Incidental primary breast cancer showed an non-significant trend of a higher percentage irregular margin (p = 0.056). All of the four incidental breast lesions with non-mass-like enhancement were proven to be malignant.Conclusion
Routine contrast-enhanced chest CT can reveal sufficient details to allow for the detection of unsuspected breast lesions, in which some cases may be proven as malignant. An irregular margin of incidental enhancing breast lesion can be considered a suggestive sign of malignancy. 相似文献17.
Rehab Abdel Rahman El Bakry 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):529-535
Objectives
Comparison between digital mammography alone and with adding digital breast tomosynthesis in breast cancer screening.Patients & methods
143 females underwent digital mammography, digital breast tomosynthesis and breast ultrasound.Results
DBT+DM decreased recall rate by 38% in BI-RADS 0. From BI-RADS I till BI-RADS V DBT+DM showed more accuracy than DM. In BI-RADS IV DBT+DM decreased false positive results by 33%.Conclusion
Adding digital breast tomosynthesis to digital mammography improves the diagnostic accuracy in breast cancer screening. 相似文献18.
Hoda Abdel Kareem Ahmed Abdel Rady 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):903-907
Background
Early diagnosis is crucial in management of pancreatic malignancy. DWMRI could be used in differentiating pancreatic lesions and judge about tumor aggressiveness.Patients & methods
Fifty patients were included in this prospective study with mean age ±43?years. Histopathology & follow up clinical results revealed 34 malignant and 16 benign lesions. All patients underwent non-contrast MRI examination and DWI at different b-values with ADC value measurements.Results
Conventional MRI poorly diagnosed pancreatic focal lesions with 79% Sensitivity, 68% specificity & 76% accuracy. In DWI with high b-value of 1000, 31/34 malignant lesions showed restricted diffusion with low ADC value (≤1.5?×?10?3?mm2/s) while 14/16 benign lesions showed mixed diffusion with higher ADC values (≥1.7?×?10?3?mm2/s). DWI at high b-value of 1000 with chosen ADC value of 1.5 as a cut-off value revealed high sensitivity (91.18%), 87.5% specificity, 93.84% PPV, 82.35% NPV and 90% accuracy in differentiating benign from malignant pancreatic lesions.Conclusion
DWMRI found to be a simple and non-invasive tool that aid in the diagnosis of pancreatic pathology with recommended high b-value and a cut-off ADC value of 1.5 that approved the highest sensitivity & specificity in differentiating benign from malignant pancreatic focal lesions. 相似文献19.
Sally Emad-Eldin Marie N. Grace Manal H. Wahba Rana M. Abdella 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):884-891
Purpose
Our aim was to evaluate the diagnostic potential of diffusion-weighted (DW) and dynamic contrast enhanced MRI (DCE-MR) in the diagnosis and characterization of complex ovarian lesions.Patients and methods
We prospectively evaluated 59 patients with 65 complex ovarian lesions detected at US. MRI examinations were performed using a 1.5?T MRI machine. Masses were classified as benign (n?=?30), borderline (n?=?7) and malignant (n?=?28). Regions of interest were drawn and parameters were calculated such as apparent diffusion coefficient (ADC) values for the diffusion; maximum absolute enhancement (SI-max), maximum relative enhancement (MRE), time to peak (T-max) and wash-in-rate (WIR) for the dynamic parameters.Results
There was a significant difference in ADC values (P?<?0.001), SI-max (P?<?0.05), MRE% (P?<?0.001), T-max (P?<?0.001) and WIR (P?<?0.001) between benign and borderline/invasive malignant groups. A cut-off ADC value?≤?0.95 had a PPV of 81.8% for prediction of borderline/invasive malignant lesions; a cut-off Tmax?≤?141?s had a specificity of 86.7% and PPV of 86.7% for predicting malignancy.Conclusion
The addition of DW and DCE-MRI to the conventional MRI improved its diagnostic value. They provide additional information for the lesion behavior. Thus they are recommended to be added to the routine conventional MRI to help characterization of complex masses. 相似文献20.
Ritsuko Fujimitsu Mikiko Shimakura Hiroshi Urakawa Ayako Morita Yoshinobu Shinagawa Keiko Sakamoto Kengo Yoshimitsu 《Japanese journal of radiology》2016,34(7):508-514