Objective To investigate the clinical value of MRI in the preoperative evaluation of breast cancer compared with mammography and ultrasonography. Methods A total of 35 patients with breast cancer were examined preoperatively with dynamic contrast enhanced MRI, mammography and ultrasonography. The findings were evaluated and compared with surgical biopsy. Results The detection rates of breast cancer with MRI, mammography and ultrasonography was 100%, 74.29% and 82.86%, respectively. MRI, mammographic and ultrasonographic measurement of tumor size had correlation coefficient to pathologic findings (r=0.94, 0.87, 0.70, respectively). The sensitivity, specificity, and accuracy of detection of intraductal spread of MRI, mammography and ultrasonography was 100%, 80.00% and 88.57% (P＜0.05), 66.67%, 95.00% and 82.86% (P＞0.05), 33.33%, 95.00% and 68.57% (P＞0.05), respectively. Conclusion MRI can detect breast cancer, especially intraductal spread more sensitively than mammography and ultrasonography.

Objective To observe the imaging features of primary hepatic endocrine carcinoma. Methods Three patients with primary hepatic endocrine carcinoma proven pathologically were retrospectively analyzed. Results Single liver lesion was detected in all 3 patients, 2 in right and 1 in left lobe of liver. The maximum diameter of the masses was 4.8 cm, 6.7 cm and 10.0 cm, respectively. The masses were all solid with different extent of low density. The solid part enhanced greatly in contrast enhanced CT scanning, while the non-solid part did not. The bigger lesions pushed the vascular to move aside in 2 patients. Enhanced and circuitous vascular was observed in 1 lesion. Slightly low signal was noticed on MR T1WI , while high signal was found on T2WI and DWI. Conclusion CT and MR can show specific features of primary hepatic endocrine carcinoma, i.e. usually single solid mass with various low densities inside and the solid part enhancing dramatically.

Objective To investigate the value of multislice spiral CT in evaluating the parametrial invasion of cervical carcinoma. Methods 75 cases of FIGO staging II cervical carcinoma who had received the surgery were studied. Their imaging and the FIGO staging were analyzed retrospectively. Results For FIGO staging, the accuracy for evaluating the parametrial invasion was 53.3%(40/75), the rate of underestimation was 26.7%(20/75), the rate of overestimation was 20.0%(15/75); For CT, the accuracy of evaluating the parametrial invasion was 69.3%(52/75), the rate of underestimation was 14.7%(11/75), the rate of overestimation was 17.3%(13/75). In 40 cases, both FIGO staging and evaluation by CT were consistent with the surgical results. In 35 cases, FIGO staging was different from the surgical results. In 29 cases, evaluation by CT was different from the surgical results. In 10 cases, CT could correct the error of FIGO staging. Conclusion CT scan can acquire the multi-plane image, and can directly reflect the parametrial space. It is more accurate than FIGO staging, and is an important complement to FIGO staging.

In light of the IT development in hospitals, the authors point out the necessity of setting up the post of CIO and clarify the role of the CIO in the construction and management of the hospital information system. They argue that the CIO should not only be in charge of the technology support of the information network platform, but also exercise the function of managing hospital information. While hospitals ought to attach importance to the development and application of information systems and the role of the CIO, the CIO, on his part, ought to try to enhance his competence and become a versatile talent expert at various disciplines like medicine, management and the computer.

Objective To quantify the perfusion parameters of normal pancreas and pancreatic carcinoma with three-dimension (3D) fast spoiled gradient echo dynamic contrast enhanced (DCE) MRI on 3.0T MR system, and to assess the value of 3D DCE-MRI in the diagnosis of pancreatic carcinoma. Methods Thirty-four patients with pathology verified pancreatic carcinoma and 31 control subjects with normal pancreas (without pancreatic diseases) underwent DCE-MRI with 3D LAVA sequence of ten phases. The data were processed on ADW 4.2 workstation. The perfusion parameters of the head, body and tail of normal pancreas, together with lesion and non-lesion area of pancreatic carcinoma were measured and statistically analyzed, including signal enhancement ratio at 30 s after injection (SER_(30)), signal enhancement ratio at 90 s after injection(SER_(90)), positive enhancement integral (PEI), time to peak (TTP) and maximum slope of increase (MSI). Results There was no significant perfusion difference among head, body or tail of normal pancreas (P>0.05). The difference of SER_(30), PEI, TTP and MSI between lesion and non-lesion region of carcinous pancreas was significant (P<0.05). The TTP between normal pancreas and the non-lesion region of carcinous pancreas was significantly different (P<0.05). Conclusion Normal pancreas has no regional perfusion difference. The data from DCE-MRI provide reliable information for the diagnosis of pancreatic cancer, and for the assessment of the invasion of pancreatic carcinoma. The difference in TTP between the normal pancreas and non-lesion region of carcinous pancreas suggest the existing of potential lesions.

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis of different pathological types and grades of malignant renal tumors. Methods DWI images of 66 patients of malignant renal tumors proved pathologically were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured and analyzed statistically. Results There was significant difference between the mean ADC value of malignant renal carcinomas ([1.653±0.598]×10~(-3) mm~2/s) and that of normal renal parenchyma ([2.305±0.218]×10~(-3) mm~2/s, P<0.001). ROC curve showed that taking ADC value of lower than 2.0×10~(-3) mm~2/s as a threshold for diagnosing renal malignant tumor, the specificity, sensitivity and accuracy was 93.94%, 71.21% and 82.58%, respectively. Statistical differences were found between clear cell carcinoma and non-clear cell carcinoma (P=0.001), as well as clear cell carcinoma grade Ⅰ and Ⅲ (P=0.002), grade Ⅱ and Ⅲ (P=0.004) respectively. However, no statistical difference was observed between grade Ⅰ and Ⅱ (P=1.000). Conclusion 3.0T MR DWI can be used in diagnosis of malignant renal tumors, and ADC value may help to differentiate the pathological type and grade.

Objective To assess the value of rigid wall and outer coarse signs in 64-slice CT for pre-operation stages of colorectal carcinoma. Methods One hundred and twenty-three colorectal carcinoma patients underwent 64-slice CT;then rigid wall and out coarse signs were evaluated respectively. The tumors were grouped according to the postoperative pathologic infiltrative depth. Two signs of the neighboring infiltrative depth groups were compared and analyzed, so as the relativity between two signs and tumor infiltrative depth. Results Among all 123 patients, 7 were Tis, 6 were T1, 14 were T2a, 16 were T2b, 75 were T3 (including 22 infiltrate to chorion and 53 infiltrate through chorion) and 5 were T4. According to the pathologic infiltrative depth, the patients were grouped into GroupⅠ: Tis+T1;GroupⅡ: T2a;Group Ⅲ: T2b;Group Ⅳ: T3a;Group Ⅴ: T3b+T4. Significant difference of the incidence of rigid wall was found between GroupⅠand Ⅱ (P=0.013), while of outer coarse between Group Ⅱ and Ⅲ (P=0.004). Coefficient correlation of rigid wall, outer coarse and the infiltrative depth of the tumor were detected (r=0.673, r=0.528, respectively, both P＜0.001), also between the two signs (r=0.725, P＜0.001). To predict the tumor of and above T1 with rigid wall and tumor of and above T3a with outer coarse, the sensitivity, specificity and accuracy was 92.30% and 79.31%, 89.09% and 69.44%, 89.43% and 76.42%, respectively. Conclusion The sign of rigid wall is valuable to distinguish the pathological changes in the tumor of and above T1, while outer coarse is better to distinguish the pathological changes of and above T2a, but not good at distinguishing tumors of T2b and T3 or above. Rigid wall and outer coarse are both in positive correlation with the infiltrative depth of the tumor, and each has different values. Combination of the two signs may be helpful to raise the accuracy for pre-operation staging of colorectal carcinoma.

Objective To investigate the diagnostic value of breast MRI in patients presenting with microcalcifications on mammography.Methods Eight four patients were retrospectively analyzed,who had mammographically detected BI-RADS (breast imaging reporting and data system) 3 to 5 microcalcifications and underwent breast MRI before surgical biopsy.All mammography and MR images were reviewed with BI-RADS.With histopathological diagnosis as golden standard,the sensitivity,specificity and accuracy of the two methods were calculated and compared with x2 test or Fisher exact test.The diagnostic efficacy of the two methods was compared with ROC curve.Results Pathologic examination revealed 91 lesions in 84 patients including 49 benign lesions and 42 malignant lesions.For 21 lesions of category 3 microcalcifications,the specificity of mammography and MR was 100.0％ (21/21) and 95.2％ (20/21),which had no significant difference (P=1.000).For 51 lesious of category 4,sensitivity,specificity and accuracy of mammography were 100.0％(23/23),0 and 45.1％(23/51).The corresponding values for MR were 91.3％(21/23),82.1％ (23/28) and 86.3％ (44/51).The difference for specificity and accuracy between the two methods was statistical significant(x2 value was 30.030 and 19.182,respectively,with P＜0.01),but not for sensitivity(x2=0.523,P=0.470).Nineteen lesions of category 5 were all correctly diagnosed on mammography and MRI.For all the 91 lesions,the sensitivity,specificity and accuracy of mammography were 100.0％(42/42),42.9％(21/49) and 69.2％(63/91),respectively.The corresponding values for MRI were 95.2 ％(40/42),87.8％(43/49) and 91.2％(83/91).There was significant difference for specificity and accuracy between the two methods (x2 value was 21.798 and 13.851,respectively,with P＜0.05),but not for sensitivity (x2=0.512,P=0.474).The areas under ROC curve for mammography and MR were 0.844,0.945(P＜0.01),for the estimation of the benign and the malignent.Conclusions Compared with mammography,breast MRI significantly improved the diagnosis of category 4 microcalcifications with increased specificity and accuracy.But for microcalcifications of category 3 and 5,MR didn't improve the diagnostic effect.

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis, histological grade, tumor staging and short-time therapeutic outcome of clear cell renal cell carcinomas (CCRCC). Methods DWI of 51 patients of CCRCC confirmed with surgery and pathology were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured. Taking ADC value at 1.8×10~(-3) mm~2/s as a cut-off value, the patients were divided into two groups. The tumors' histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up were compared between the two groups with statistical test. Results Statistical difference of ADC value was observed between CCRCC ([1.778±0.582]×10~(-3) mm~2/s) and those of normal renal parenchyma ([2.314±0.223]×10~(-3) mm~2/s) (P<0.01). ADC values of 24 patients were less than 1.8×10~(-3) mm~2/s and those of 27 patients were more than or equal to 1.8×10~(-3) mm~2/s. There were statistical differences in histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up between the two groups (P＜0.01). Conclusion 3.0T MR DWI can accurately differentiate CCRCC from normal renal parenchyma. Quantitative analysis of ADC value is helpful to evaluate the histological grade, tumor staging and short-term therapeutic outcome of CCRCC.

Objective To evaluate the ability of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) value in diagnosis of pancreatic cancer at 3.0T MR. Methods The diffusion-weigted sequences with b=800 s/mm~2 were performed in 30 patients of pancreatic cancer confirmed pathology, and in 30 control subjects with normal pancreas as well. ADC value of the cancer, pericancerous tissue and normal pancreas were recorded and statistically analyzed with ANOVA and ROC analysis. Results The mean ADC value of cancer, pericancerous tissue and normal pancreas was(1.494±0.273)×10~(-3) mm~2/s, (1.631±0.281)×10~(-3) mm~2/s and (1.778±0.237)×10~(-3) mm~2/s, respectively. ADC value of pancreatic cancer was significant different from that of the normal pancreas, while there was no significant difference between pancreatic cancer and pericancerous tissue. The one-side upper limit of 95% confidence interval of mean ADCs (1.622×10~(-3)mm~2/s)was adopted as the point to diagnosis of pancreatitis. The area under ROC curve was Az=0.800. Conclusion ADC values are helpful to differential diagnosis of pancreatic cancer and normal pancreas. DWI may be do some contribution to the diagnosis of pancreatic cancer.