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.

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 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.

Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.

Objective To study the value of magnetic resonance diffusion tensor imaging(MR-DTI) in evaluating the severity of liver cirrhosis.Methods Seventeen patients with Child A liver fibrosis (age=35.0+11.8 years,14 males and 3 females),12 with Child B(age=44.7+14.0 years,5 males and 7 females) and 8 with Child C(age=48.7+7.6 years,3 males and 5 females) were recruited.All patients had clinical data and serum makers in full.Fifty normal controls (age=35.2+14.2,28 males and 22 females) were also recruited.Diffusion tensor imaging(DTI) was performed in all subjects using a GE Propeller HD 1.5T MR scanner by employing a spin echo single-shot EPI(echo planar imaging) sequence.Average diffusion coefficient(DCave) and fractional anisotropy(FA) maps were generated from each P articipants DTI scan using AW 4.2 functool software.All the statistic analysis was performed in SPSS 13.0 , and P value of less than 0.05 was deemed to be significant . Results DCave values were 1.54±0.25 ,1.33±0.18 ,1.02±0.12 ,0.66±0.27 in control group and Child A , B , C respectively , the FA values were 0.46±0.10, 0.42±0.08, 0.56±0.05,0.71±0.41 in control group and Child A, B, C respectively. Significantly low DCave and changed FA in liver fibrosis group were found(P< 0. 05). Among the four groups, significant differences were found in DCave values and FA values(P<0.05) except control group VS Child A group in FA values(P=0.54).Conclusion MR-DTI is relevant to the severity of liver cirrhosis, and may be a useful tool for evaluating the severity of liver cirrhosis.

Objective To evaluate the value of MR and CT examinations in the diagnosis of nasopharyngeal carcinoma (NPC) and compare 2008 staging system with 1992 staging system and 2002 UICC staging system for NPC. Methods MR and CT images of seventy-six cases with NPC were studied. According to 2008 staging system and taking MR as a standard, differences between these two examinations were evaluated under the new NPC staging system, and three staging system were compared by MR findings. Results MR was inconsistent with CT in eveluating invasion of medial pterygoid muscle(22,24 cases), lateral pterygoid muscle( 15, 11 cases), skull base(35, 32 cases) and intracranial fossa( 11,6 cases), but no statistical diffence existed ( P ＞ 0. 05 ). There were statistical difference ( P ＜ 0. 05 )between MR and CT in determining invasion of parapharyngeal space( 50, 61 cases), retropharyngeal lymph node metastasis(48, 23 cases), stage T1 (18, 11 cases), T2 (15, 22 cases), N0 (18, 24 cases) and N1(33, 27 cases) with differences of 11 cases, 25 cases, 7 cases, 7 cases, 6 cases and 6cases respectively.For invasion of parapharyngeal space, CT showed 11 cases more than MR while 5 cases were comfirmed as compression by local tumor and 6 cases were proved as retropharyngeal lymph node metastasis according to MR. For retropharyngeal lymph node metastasis, MR presented 25 cases more than CT. These two reasons above mainly caused the differences of T-staging and N-staging. For 2008 staging system, when compared with 1992 staging system, there were 9 cases upstaging and 1 case downstaging in T classification, 16 cases upstaging in N classification, and 15 cases upstaging and 1 case downstaging in clinical classification; and when compared with 2002 UICC staging system, there were 7 cases, 10 cases and 12 cases upstaging in T,N, and clinical staging respectively. Conclusions Compared with MR examination which was regarded as standard by 2008 staging system of NPC, there were some differences in demonstrating invasion of parapharyngeal space and retropharyngeal lymph node metastasis by CT. Compared to 1992 staging system and 2002 UICC staging system, 2008 staging system mainly made T and N classification of tumor upstage,resulting in upstaging in clinical classification.

Objective To investigate the value of DWI before treatment on predicting sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma.Methods Seventy patients with nasopharyngeal carcinoma proved by nasopharyngoscope and biopsy pathology conducted DWI before concurrent chemoradiation and reexamined on receiving dose of 50 Gy.The mean, maximum and minimum ADC value of tumor were measured on DWI and maximum area of tumor before and during treatment ( on dose of 50 Gy) was delineated to calculate the tumor regression rate ( RS0-50 ).The patients were classified into three groups according to the RS0-50 as sensitive, moderate, and resistant therapeutic effect.Patients were classified into different groups according to the pathologic type and clinical stage respectively .Spearman correlation analysis was used between RS 0-50 and ADC values of all tumors , different pathologic types and clinical stages , respectively.ROC was used to evaluate the cutoff and value of ADC which had highest correlation to RS0-50 on predicting therapeutic effect.Results DWI of 3 patients were excluded due to obvious swallow artifact which influenced the measurement , and finally 67 patients were included in this study, with pathological type of nonkeratinized differentiated undifferentiated carcinoma in 49 cases, nonkeratinized undifferentiated carcinoma in 18 cases, clinical T1 stage in 7 cases, T2 in 14 cases, T3 in 17 cases and T4 in 29 cases.During treatment , there were 13 cases with sensitive therapeutic effect , 42 cases with moderate therapeutic effect and 12 cases with resistant therapeutic effect.RS0-50 [ ( 65.6 ± 3.1) %] showed mildly and moderately negative correlation to mean ADC [(1.06 ±0.19) ×10 -3 mm2/s] and maximum ADC [(1.29 ±0.33) ×10 -3 mm2/s] respectively ( r =-0.276, P =0.024 and r =-0.434, P=0.001, respectively).ROC showed when setting threshold at maximum ADC value of lower than 1.06 ×10 -3 mm2/s for predicting sensitive therapeutic effect , the specificity , sensitivity , and accuracy was 69.2%(9/13), 88.9%(48/54) and 85.1% (57/67), respectively, and when setting threshold at maximum ADC value of higher than and equal to 1.30 ×10 -3 mm2/s for predicting resistant therapeutic effect, the specificity, sensitivity, and accuracy was 75.0% (9/12), 65.5% (36/55) and 67.2%(45/67), respectively.Conclusion Pretreatment maximum ADC value were able to predict the tumor regression rate and sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma .

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.