Benefits of the DICOM Structured Report

Recently, the digital imaging and communications in medicine (DICOM) standard introduced rules for the encoding, transmission, and storage of the imaging diagnostic report. This medical document can be stored and communicated with the images in picture archiving and communication system (PACS). It is a structured document that contains text with links to other data such as images, waveforms, and spatial or temporal coordinates. Its structure, along with its wide use of coded information, enables the semantic understanding of the data that is essential for the Electronic Healthcare Record deployment. In this article, we present DICOM Structured Report (SR) and discuss its benefits. We show how SR enables efficient radiology workflow, improves patient care, optimizes reimbursement, and enhances the radiology ergonomic working conditions. As structured input significantly alters the interpretation process, understanding all its benefits is necessary to support the change. Biography Rita Noumeir is a professor at the Department of Electrical Engineering of the University of Quebec, école de Technologie Superieure in Montreal. A founding member of the Imaging, Vision, and Artificial Intelligence Laboratory (LIVIA), her main research interest is the Healthcare Information Technology, specifically, Interoperability, Electronic Patient Record, Security, Information Confidentiality, and Image Processing. As a member of both Technical and Planning International IHE Radiology Committees, Dr. Noumeir took part over the last 5 years in developing many Integrating the Healthcare Enterprise (IHE) Integration Profiles in Radiology and in organizing several Integration Demonstrations. She is a cofounder of IHE Canada. Dr. Noumeir contributed to many research and development projects in collaboration with several Canadian and international companies in medical imaging and healthcare information. Currently, she collaborates with the Diagnostic Imaging Team of Canada Health Infoway to define the principles and architecture for sharing imaging information between multiple healthcare institutions. She plays a leading role in the development of this solution that is published as an IHE Integration Profile for which she is the editor. Rita Noumeir holds a Ph.D. and a Masters degree in Biomedical Engineering from école Polytechnique of Montreal specializing in Medical Imaging. She is a professional engineer, and a member of the Ordre des ingénieurs du Québec.     

In vivo fluorescence spectroscopy and imaging of human skin tumours

The feasibility of using in vivo autofluorescence for the diagnosis of skin cancer was evaluated. In vivo fluorescence measurements were performed on healthy human volunteers, and patients with different types of benign and malignant skin tumours. Fluorescence spectra as well as fluorescence images were acquired. The excitation-emission matrix of normal skin (n=3) showed a broad peak at the shortest excitation wavelength (365 nm) and at 440 nm fluorescence wavelength, smoothly decreasing towards longer excitation and fluorescence wavelengths. Non-melanoma skin tumours (n=31) and control skin excited with 375 nm showed a broad fluorescence band from 400 to 700 nm, peaking around 436 nm. No significant differences in measurements between tumours and the corresponding control sites were found. A large spatial variation in the fluorescence intensity was observed both in the tumours and in the control sites. Standard deviations found ranged from 0.15 to 1.5 times the mean fluorescence. Fluorescence images, excited with 375 nm and taken with an image intensified CCD camera, on eight malignant melanomas and eight benign pigmented lesions did not indicate any fluorescence intensity distribution specific to the malignancy of the lesion. Neither the shape of the fluorescence spectra, nor the spatial distribution of the fluorescence intensity showed any signature specific to the histopathological nature of the lesions investigated. Optical diagnostics of skin tumours using the autofluorescence does not seem to be feasible at the present time.     

八例巨大型颈静脉球瘤的影像学研究

目的提高对颈静脉球瘤的影像学认识和诊断。方法对8例经病理明确诊断的颈静脉球瘤的影像学资料进行回顾性分析。结果6例巨大型颈静脉球瘤MRI出现特异型表现,即典型的“盐和胡椒”征;DSA检查不仅能够术前明确肿瘤供血血管,而且同时进行栓塞治疗可减少随后术中出血。结论MRI DSA是巨大型颈静脉球瘤术前最有价值的影像学检查工具。     

弥散张量磁共振成像方法概述

弥散张量成像(diffusion tensor imaging,DTI)是一种根据组织内水分子的弥散特性来探测有机体的微观结构和病理改变的核磁共振成像方法,目前已经成为临床评估和生命科学研究重要的工具。本文结合近年来的文献综述了弥散张量成像的基本原理,列举了目前常用的成像方法,分析了它们的优缺点以及用途,并对弥散张量成像的发展方向作了一些展望。     

女性控尿解剖学机制的MRI研究

目的探讨女性控尿的解剖学机制在MRI（磁共振成像）的表现和观察方法。方法对20例正常控尿的成年女性进行MRI扫描，采用八通道体部线圈、快束自旋回波（FSE）扫描序列进行扫描，采集静息时盆腔横断面、矢状面和冠状面影像。结果MRI显示，女性的尿道分三层结构，与病理学对照，由内向外依次为黏膜及黏膜下组织、肌肉、外膜组织，但无法区分平滑肌与括约肌；与控尿有关的盆底肌肉也能够清楚显示。结论MRI能够清楚观察到女性控尿的有关解剖结构，是观察女性控尿解剖结构的较理想影像方法。     

腮腺间隙良性肿瘤的MRI诊断

目的探讨腮腺间隙常见良性肿瘤的影像特征及其诊断与鉴别诊断。方法良性肿瘤20例，包括多形性腺瘤13例、乳头状淋巴囊腺瘤3例、淋巴管瘤2例、血管瘤1例、脂肪瘤1例。经手术病理证实15例，穿刺活检证实4例，典型MR特征结合病史确诊1例。结果13例多形性腺瘤中有11例位于腮腺浅叶，2例位于深叶；9例表现为均匀等T1长T2信号．4例在T2WI上信号明显不均匀；静脉注射Gd—UIPA后3例瘤实质均匀强化，4例增强后明显不均匀强化。3例Warthin瘤中2例发生于一侧，1例累及双侧腮腺，在T1WI上呈低信号，T2WI上信号等于或低于正常腺实质，增强后无明显强化。2例淋巴管瘤呈明显长T1长T2信号，并有多房现象。1例血管瘤信号不均质，呈明显长T1长T2信号，静1脉注射Gd—DTPA后病变往往显著异常强化。1例脂肪瘤在T1WI及T2WI上均表现为明显高信号强度。结论运用MR成像研究腮腺间隙的良性肿瘤，有利于疾病的定位，有助于病变的诊断与鉴别诊断。     

33例肝占位性病变MRI误诊的分析

我院１９８８年以来４０００余例腹部ＭＲＩ中，发现肝占位性病变误诊３３例。所用机型为美国Ｄｉｓｏｎｉｃｓ公司０．５Ｔ超导ＭＲＩ，自旋回波序列（ＳＥ序列）、常规Ｔ１加权（Ｔ１ＷＩ）、质子加权（ＰＤＷＩ）、Ｔ２加权（Ｔ２ＷＩ），覆盖全肝。其中，ＰＨＣ误诊为ＭＨＣ５例、ＭＨＣ误诊为ＰＨＣ６例、ＰＨＣ误为ＨＨＥ５例、ＭＨＣ误诊为ＨＨＥ２例、ＨＨＥ误诊为ＰＨＣ６例、肝硬化结节误诊为ＰＨＣ２例、炎性假瘤误诊为ＰＨＣ３例、肝结核误诊为ＰＨＣ１例、ＨＣＹ误诊为ＨＨＥ３例。本文从病变的影像学特征和扫描技术方面详细探讨了误诊的原因和鉴别诊断要点。     

Evaluation of blood flow patterns of true and false lumens in dissecting aneurysms using MR phase-contrast techniques

The magnetic resonance phase-contrast technique for the measurement of flow velocity and volume in true and false lumens was studied in six patients with chronic dissecting aneurysms. Phase-contrast images were obtained at a level perpendicular to the dissecting aneurysms of the descending aorta. As the maximum diameter of aneurysms increased, the ratio of the cross-sectional area of the false to the true lumen increased and the peak average velocity in the true lumen during systole was decreased. This technique proved invaluable for determining prognosis and operability for this condition.     

Localization of adhesion molecules on human spermatozoa by fluorescence microscopy

Summary.  The expression of adhesion molecules on human spermatozoa of healthy probands was analysed. The localization patterns of adhesion molecules (AM) on the spermatozoal surface were documented by fluorescence microscopy. Spermatozoa were incubated with antibodies against α1 (CD49a), α2 (CD49b), α3 (CD49c), α4 (CD49d), α5 (CD49e), α6 (CD49f) chains of β1 integrins, β1 (CD29), β2 (CD18), αV (CD51), β3 (CD61) and β4 integrin chains, the LFA-3 (Lymphocyte function antigen, CD58) from the immunoglobulin superfamily and the extracellular matrix proteins laminin, fibronectin and collagen IV. For collagen IV, α1 and α2 chains no expression could be noticed. Laminin was detected at the acrosomal membrane, fibronectin and β4 chain mainly at the equatorial membrane. The fibronectin receptors α3, α4 and α5 chains of the β1 integrins were mainly located on acrosomal and equatorial membrane areas. Laminin receptor α6 chain was located postacrosomal and less frequently acrosomal. β2 chain and vitronectin receptors αV and β3 chains had a mainly postacrosomal localization pattern. LFA-3 was found constantly on postacrosomal membrane areas. Double staining technique was used to prove the simultaneous occurrence of fibronectin and its integrin receptors α3, α4 and α5 chains and of αV and β2 chains on spermatozoa. The localization patterns of integrins on double stained spermatozoa were similar to the patterns described for single stained spermatozoa. The localization of fibronectin appeared to be influenced by the presence of integrins: the typical equatorial fibronectin band disappeared in case of an equatorial localization of integrins.