BACKGROUND:The diagnosis of osteoporosis depends upon the bone mineral density T-score of ≤ -2.5 standard deviation or brittle fractures. Bone mineral density measurement combined with vertebral fracture assessment might prevent the missed diagnosis of osteoporosis due to bone mineral density evaluation alone, and improve the diagnosis rate of osteoporosis.
OBJECTIVE:To evaluate the effect of bone mineral density measurements combined with vertebral fracture assessment for the diagnosis of osteoporosis.
METHODS:Bone mineral density measurements of proximal femur and vertebral fracture assessment for lateral thoraco-lumbar images were consecutively done for 217 postmenopausal women who aged ≥ 50 years. The rate of osteoporosis diagnosed with bone mineral density T score was compared with that diagnosed with bone mineral density combined with vertebral fracture assessment. The effects of bone mineral density on the vertebral fracture were analyzed.
RESULTS AND CONCLUSION:92 (42.4%) patients had bone mineral density T score ≤ -2.5, which met the threshold for diagnosis of osteoporosis. 102 (47.0%) patients had osteopanic (-1>T>-2.5) and 23 (10.6%) had normal range of bone mineral density. 158 patients had no vertebral fractures and 59 (27.2%) patients had 101 vertebral fractures. The vertebral fracture rate was 21.6%in the patients with bone mineral density T> -2.5 and 34.8%in the patients with bone mineral density T ≤ -2.5, with significant differences (P<0.05). Bone mineral density in combination with vertebral fracture assessment for the diagnosis rate of osteoporosis was up to 54.8%, which was significantly higher than the rate diagnosed with only bone mineral density (12.4%;P=0.01). Bone mineral density measurement combined with vertebral fracture assessment improves the diagnosis of osteoporosis for postmenopausal women.

BACKGROUND:The prevalence of osteoporosis is high in the patients undergoing total hip arthroplasty. Osteoporosis is associated with the survival of prostheses. Both canal flare index and bone mineral density are aged-related.
OBJECTIVE:To study the cxorrelation between canal flare index of the proximal femur and bone mineral density of femoral neck, and to pay more attention to osteoporosis.
METHODS:A retrospective study of the correlation between canal flare index of the proximal femur on pelvic radiograph and bone mineral density of femoral neck was made in 57 patients undergoing total hip arthroplasty.
RESULTS AND CONCLUSION:The canal flare index were ranged 1.8-4.8 (3.1±0.7) in 57 patients. There were 23 patients in canal flare index<3 (chimney-type medul ary cavity), 33 in canal flare index between 3 and 4.7 (normal-type medul ary cavity), and one in canal flare index>4.7 (funnel-type medul ary cavity). The age had an impact on the type of medul ary cavity. The prevalence of chimney-type medul ary cavity were significantly higher in>60 years old group than≤60 years old group, and bone mineral density of femoral neck in the group of canal flare index≥3 was significantly higher than the group of canal flare index<3. The bone mineral density of femoral neck was gradual y reduced with age, and were significantly higher in≤60 years old group than in>60 years old group [(0.751±0.235) g/cm2, (0.590±0.092) g/cm2, P=0.000]. As bone mineral density reduced, canal flare index was also decreased. Experimental findings indicate that, the bone mineral density of femoral neck is significantly correlated with canal flare index.

Objective To explore the value of non-contrast MRI for diagnosing cesarean scar pregnancy(CSP)developed placental implantation(PI)in early pregnancy.Methods Totally 79 pregnant women with CSP in early pregnancy were retrospectively enrolled.According to postoperative pathology,PI was diagnosed when villi tissue or trophoblast cells were found in the scar muscle(PI group,n=23),while single CSP was diagnosed when no villi nor trophoblast cells were detected in the scar muscle(CSP group,n=56).Preoperative non-contrast pelvic MRI parameters were compared between groups,and the efficacy of MRI quantitative parameters for diagnosing CSP developed PI in early pregnancy was evaluated.Results Compared with those in CSP group,the largest area of the pregnancy sac,the length of the pregnancy sac close to the scar were both larger,the thickness of the thinnest scar was smaller,and the proportion of empty blood vessels shadow around the scar was higher in PI group(all P＜0.01).The sensitivity of the largest area of the pregnancy sac,the length of the pregnancy sac close to the scar and the thickness of the thinnest scar for diagnosing CSP developed PI was 78.26％,82.61％and 91.07％,respectively,and the specificity was 67.86％,66.07％and 69.57％,respectively,with area under the receiver operating characteristic curve of 0.76,0.79 and 0.82,respectively.The sensitivity,specificity and accuracy of empty blood vessels shadow around the scar for diagnosing CSP developed PI was 78.26％(18/23),85.71％(48/56)and 83.54％(66/79),respectively.Conclusion Non-contrast MRI had important clinical value for diagnosing CSP developed PI in early pregnancy.

Objective To develop a mammogram microcalcification detection model(DL model)based on Attention U-Net for realizing the efficient detection of microcalcifications,and to investigate the effects of breast density and microcalcification type on the microcalcification detection performance of the DL model.Methods A retrospective analysis was performed on 694 images from 347 patients undergoing mammography.Through the independent image diagnosis by junior physicians and review by senior physicians,the reference standard for microcalcification detection was established.Neural network training was performed to establish a DL model.The performance of the model for microcalcification detection was evaluated using precision rate,recall rate,intersection over union(IoU)and F1-score which were calculated based on calcification area or quantity;and the effects of microcalcification type(benignvsmalignant)and breast density(a+bvsc+d)on the model performance were also analyzed.Results For detecting microcalcifications by the DL model,the precision rate,recall rate,IoU and F1-score were 85.12%±18.39%,78.18%±19.25%,68.29%±21.39%and 78.96%±17.70%when the calculation was based on calcification area,and those were 76.72%±19.85%,85.12%±18.39%,67.13%±23.84%and 77.65%±9.37%when the calculation was based on calcification quantity.The differences in precision rate,recall rate,IoU,F1-score of DL model in different microcalcification types(benignvsmalignant)and breast densities(a+bvsc+d)were insignificant.Conclusion The developed mammogram microcalcification detection model based on Attention U-Net can effectively detect breast microcalcifications and is conducive to the quantitative research on breast microcalcifications.Meanwhile,the model exhibits high stability,and the breast density and microcalcification type have trivial effects on the microcalcification detection performance of the model.

To explore the effect of digital breast tomosynthesis (DBT) on the classification of breast imaging-reporting and data system (BI-RADS) and its significance.
 Methods: A total of 832 patients with breast diseases, who came from Second Clinical College of Fujian Medical University from May 2013 to November 2013, were collected. The patients were examined by double position radiography (including craniocaudol and mediolateral oblique) and COMBO mode [including DBT and full-field digital mammography (FFDM)]. Meanwhile, the results of FFDM and DBT were classified. The number of glands, the characteristics of mass and other indirect signs were compared by COMBO and FFDM modes. Paired Wilcoxon rank sum text was adopted to investigate the differences between COMBO mode and FFDM mode in the 832 patients, and receiver operator characteristic curve (ROC) was applied to analyze the 79 patients with the pathological results.
 Results: The patients with large amount of glands (including Class c and Class d) accounted for 87.6% in the 832 patients, while the patients with small amounts of glands (including Class a and Class b) accounted for 11.7%. In estimating the content of glands, more details about the distribution of glands were found in the COMBO mode compared with those in the FFDM mode. According to the results of paired Wilcoxon rank sum test, there was significant statistical difference in BI-RADS classcification in breast masses between the COMBO mode and the FFDM mode (P<0.05), though the overall classification of the COMBO mode is higher than that of the FFDM mode. The pathology was served as a standard to estimate the diagnostic efficiency. The area under ROC curve was 0.805 in the FFDM mode, while that in the COMBO mode was 0.941. The optimal sensibility in the COMBO mode was 82.9%, which was higher than that in the FFDM mode. However, the specificity was 93.2% in both COMBO mode and the FFDM mode.
 Conclusion: DBT has a high clinical significance in BI-RADS classification for breast X-ray examination.
Breast Neoplasms ; diagnostic imaging ; Comparative Effectiveness Research ; Female ; Humans ; Mammography ; methods ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: Clarifying the expression of breast cancer receptor is the key to clinical treatment for breast cancer. This study aims to explore the correlation between X-ray and clinical characteristics of 4 molecular subtypes and their receptor types of breast cancer. METHODS: A total of 439 breast cancer patients who confirmed by pathology and performed X-ray examination were enrolled. The X-ray and clinical characteristics of 4 molecular subtypes and the expression of their receptors were analyzed. RESULTS: Luminal A type showed the highest proportion of spiculate masses, and the lowest calcification score, showing significant difference with other 3 subtypes (all CONCLUSIONS Four molecular subtypes of breast cancer and their receptor expressions are correlated with X-ray and clinical characteristics, which can provide a basis for clinical diagnosis and treatment.
Biomarkers, Tumor ; Breast Neoplasms/genetics* ; Female ; Humans ; Receptor, ErbB-2/genetics* ; Receptors, Estrogen ; Receptors, Progesterone ; X-Rays