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 investigate whether quantitative dynamic contrast enhanced MR can predict final pathologic response in primary breast cancer patients undergoing neoadjuvant chemotherapy (NAC).Methods Forty seven patients who were pathologically proved infiltrating ductal carcinoma with core needle puncture biopsy were examined before NAC and after 2 cycles of treatment and the quantitative parameters (Ktrans,Kep and Ve) were analyzed prospectively.Histological response is categorized as non-major histological response (NMHR) and major histological response (MHR).Quantitative parameter changes measured after 2 cycles of NAC were compared between MHR and NMHR using non parametric tests (Mann-Whitney U test) and pretreatment parameters were compared using independent samples t tests.Receiver operating characteristic curve (ROC) was used to determine the best predictor and cutoff value.Results Fifteen patients were grouped into MHR and 32 patients were NMHR.Pretreatment parameters(Ktrans,Kep and Ve) were(1.51 ±0.33) /min,(2.97 ± 1.06) /min and (0.55 ±0.16) in MHR and (1.53 ±0.40) /min,(2.82 ± 0.99) /min and (0.57 ± 0.20) in NMHR.There was no significant difference between the two groups (t values were-0.123,0.450 and-0.380,respectively,P ＞ 0.05).Changes inkinetic parameters(K,Kep and Ve) were-88.2％ (-96.0％ to 1.5％),-62.5％ (-94.3％ to -8.7％) and-57.0％(-82.1％ to 55.5％) in MHRand-8.1％(-88.5％ to 32.4％),-18.2％ (-62.1％ to 145.9％) and-4.7％ (-83.1％ to 95.7％) in NMHR.There were significant difference between the two groups (Z values were 4.359,4.359 and 3.332,respectively,P ＜ 0.01).The areas under ROC curve of AKtrans,AKep and Ktrans after 2 cycles of NAC were all 0.898.Sensitivity of the three parameters for predicting NMHR were 87.5％,90.6％ and 78.1％,and specificity were 86.7％,80.0％ and 93.3％,respectively.Conclusion Quantitative dynamic contrast enhanced MRI can predict final pathologic response in primary breast cancers after 2 cycles of NAC.

Objective To explore the value of diffusion weighted imaging(DWI) in the diagnosis of invasive ductal carcinoma not otherwise specified and find a suitable diagnostic cutoff ADC value.Methods The MRI findings of 69 patients (69 lesions) of invasive ductal carcinoma not otherwise specified and 67 patients benign tumors (69 lesions) confirmed by pathology were evaluated.ADC values of the carcinoma,benign tumors and their contralateral normal breast tissues were obtained.Independent-samples t test and ROC curves were used.Results The ADC values of carcinoma and contralateral normal breast tissues were (0.925 ± 0.268) × 10-3 mm2/s and (1.680 ± 0.446) × 10-3 mm2/s respectively,their difference had statistical significance (t =12.08,P ＜ 0.01) ; The ADC values of benign tumor and contralateral normal breast tissues were (1.350 ± 0.383) × 10-3 mm2/s and (1.690± 0.356) × 10-3 mm2/s respectively,the difference had statistical significance (t =6.64,P ＜ 0.01); The difference between carcinoma and benign tumors had statistical significance as well (t =7.56,P ＜ 0.01).The area under the ROC curve of carcinoma and contralateral normal breast tissues,benign tumors and contralateral normal breast tissues,carcinoma and benign tumors were 0.915,0.794,0.847 respectively.The diagnostic cutoff value for each were 1.185 × 10-3 mm2/s,1.505 × 10-3 mm2/s,1.015 × 10-3 mm2/s respectively;Corresponding sensitivity and specificity were 89.9％ and 85.5％,79.7％ and 63.5％,75.4％ and 87.0％respectively.Conclusions MR-DWI is valuable in the diagnosis of invasive ductal carcinoma not otherwise specified.The best ADC diagnostic cutoff value to differentiate invasive ductal carcinoma not otherwise specified from benign tumors is 1.015 × 10-3mm2/s.

Objective To retrospectively compare CT and MR features of hepatocellular adenoma with pathologic findings.Methods Twelve patients with histopathologically proved hepatocellular adenoma were classified on the basis of pathologic and genotype phenotype findings into four groups:steatotic type,cytological abnormality type,telangiectatic adenoma with inflammatory infiltrates type and atypical adenoma type.The CT and MR features of each type were reviewed retrospectively compared with the pathological results.Results In this retrospective study,12 patients were examined with CT (8 patients) and MR (8 patients).Among 12 patients,4 patients showed a steatotic type.One patient showed hypo-density on the non-enhanced CT and 3 patients demonstrated hypo-density on all phases of the post-contrast scans.Two lesions showed iso-intense signal on the in-phase T1 WI with signal dropout on the out-of-phase T1WI,and hypo-intense signal on the T2 WI with fat suppression sequences.One lesion demonstrated moderate hypointense signal on all phases of the post-contrast MRI scans.Two patients with the telangiectatic adenoma irflammatory infiltrates type were found.One patient showed hypo-density on the non-enhanced CT scans and hyper-density on all phases of the post-contrast CT scans.One patient demonstrated iso-intense signal and the other hypo-intense signal on the T1 WI,and both displayed moderate hyper-intense signal on the T2WI with fat suppression sequences and hyper-intense signal with gradual enhancement on all phases of post-contrast MR scans.There were 3 patients with a cytological abnormality type.One patient appeared hypodensity and 1 patient showed uniform iso-density on non-enhanced CT scans.All patients who had undergone contrast-enhanced CT scans were found to have hyper-density on the hepatic arterial-dominant phase and became slightly lower on the portal venous phase.On the delay phase the density reduced further.One mass showed iso-intense signal on the T1WI and hyper-intense signal on the T2WI with fat suppression sequences.There were 3 patients with an atypical adenoma type.One patient appeared uniform hypo-density on the nonenhanced CT and hyper-density on the hepatic arterial-dominant phase and became iso-dense on the portal venous phase.On the delay phase,it was slightly hyper-dense.Two out of the three lesions showed isointense and one hypo-intense signal on the in-phase T1 WI,and hypo-intense,hyper-intense,and iso-intense signal on the T2WI with fat suppression sequences,respectively.Two patients examined on all phases of post-contrast MRI scans.The result was similar to the CT findings.Conclusion The imaging features of hepatocellular adenoma are closely associated with pathological characteristics.

ObjectiveTo explore an individualized abdominal scan protocol with a 64-slice CT scanner.MethodsFrom Sep.2010 to Nov.2010,one hundred consecutive patients,who underwent twice non-contrast-enhanced abdominal CT scans within 3 months,were enrolled in this study.For each patient,the tube current of 274 eff.mAs and 207 eff.mAs were applied respectively in the first and second abdominal scan.The imaging qualities of the two scans were evaluated retrospectively by 3 reviewers.All the individual variants,including height,weight,body mass index (BMI),the maximum transverse diameter,the anteroposterior diameter and the average maximum diameter of abdomen were recorded.A five-point scale was used for grading the image noise of eight organs,including abdominal aorta,portal vein,liver,spleen,gallbladder,pancreas,renal cortex and renal medulla. Diagnostic acceptability of CT images at three anatomic levels,including porta bepatis,pancreas and the upper pole of renal,was also evaluated by using a five-point scale.The noise value of abdominal aorta was defined as the standard deviation (SD) of CT values of aorta at the level of porta hepatis.Scatter diagram and Pearson correlation analysis were used for evaluating the linear relationship between the individual variants and the noise value of abdominal aorta,and multivariate linear regression analysis was used for evaluating the relevance between the individual variants and the noise value of aorta.ResultsIn this patients group,the average height was ( 164.6 ± 7.5 ) cm,the average weight was (64.3 ± 11.0) kg,the BMI was (23.7 ±3.3) kg/m2,the maximum transverse diameter of abdomen was(29.8 ± 2.3 )cm,the anteroposterior diameter of abdomen was (23.1 ± 2.9) cm,and the average maximum diameter of abdomen was ( 26.5 ± 2.5 ) cm.Pearson correlation analysis showed significant positive linear correlation between the noise value of abdominal aorta( 1 1.7 ± 3.0)and patients' weight ( r =0.744,P ＜ 0.01 ),BMI ( r =0.689,P ＜ 0.01 ),the maximum transverse diameter ( r =0.813,P ＜ 0.01 ),the anteroposterior diameter ( r =0.781,P ＜ 0.01 ),the average maximum diameter of the abdomen ( r =0.789,P ＜ 0.01 ) ; however,there was no positive linear correlation between the noise value of abdominal aorta and patients' height ( r =0.292,P ＜ 0.01 ). The maximum transverse diameter of abdomen is greatly related to the noise value of abdominal aorta (Beta =0.487,P ＜0.01 ).For the patient with the maximum transverse diameter of abdomen ranging from 27 to 32 cm,diagnostic acceptability of CT images at the anatomic level of porta hepatis showed statistical significance compared with the patient with the maximal transverse diameter of the abdomen greater than 32 cm or less than 27 cm (P ＜ 0.05 ).Conclusion The tube current of 207 eft.mAs is reasonable for abdominal CT scan for patients with the maximal transverse diameter of the abdomen ranging from 27 to 32 cm.