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 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 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.

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 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.

Pre-S2 protein in 78 samples of liver from patients with various types of hepatitis B was determined by immunohistochemical method.45 out of 78 samples (57.69%) were positive for pre-S2.The location and expression patterns of pre-S2 were similar to those of HBsAg,i.e.,pre-S2 was found in cytoplasm of hepatocytes,epithelial cells of bile ducts,and hepatocellular carcinoma cells,etc,Four different patterns diffuse,inclusion,submembranous,and membranous type were demonstrated.The membranous expression of pre-S2 was often associated with activity of liver diseases.The positive rate of pre-S2 was significantly higher in HBcAg positive group than HBcAg negative group.It seems that pre-S2 protein of HBV may be a replicative marker of HBV.

Objective To investigate the short-term effects of intra-articular injection of hyaluronan on proprioception of the knee in gerontal patients with osteoarthritis (OA). Methods The 53 gerontal patients were included in this study. The study included treatment group (n=35) and the placebo group (n=18). Hyaluronan was intra-articularly injected into both knees of the subjects in treatment group, whereas physiological saline was intra-articularly injected in the placebo group. Proprioception test was performed, and Western Ontario and McMaster Universities(WOMAC) scales were used to evaluate pain and physical function. Results Statistical analysis was performed on 100 knees of 50 patients who completed the trial. Compared with the placebo group,the average absolute angular error (AAAE) value in the treatment group was detected to be statistically lower one week after the 4th injection (1.8±0.9 vs.2.9±1.1,t=2.42,P=0.02),and WOMAC was lower in the treatment group after one week (8.7±3.1 vs.11.5±4.0, t=0.73,P＜0.05). Conclusions Intra-articular injection of hyaluronan in gerontal patients with knee OA leads to a short-term increase in proprioception, and significant improvement in the functional conditions of patients.

OBJECTIVETo analyze the imaging characteristics of hepatic epithelioid hemangioendothelioma (EHE) and their correlation with histopathological findings.

METHODSCT and MRI imaging and histopathological characteristics of five patients with hepatic EHE were retrospectively reviewed and the correlation of their imaging characteristics with pathological findings was analyzed.

RESULTSA total of 92 lesions were found in the 5 patients, all presenting with multiple nodules. All the 92 lesions were located within a 2-cm zone heneath the hepatic capsule, i.e., the shortest distance from the horder of lesions to the hepatic capsule. 28 of the 92 lesions showed the "capsular retraction" sign. 36 lesions were found in three patients receiving MRI. 77.8% of the 36 lesions demonstrated the "halo" sign on a fat-suppression T2- weighted image, while 91.7% after contrast enhancement. A peripheral dark rim was found in 91.7% of the lesions on a fat-suppression T2-weighted image. In addition, 36.1% of the lesions showed slight internal or edge enhancement at the hepatohiliary phase. In the two patients receiving CT examination, 7 of 56 lesions demonstrated the "halo" sign.

CONCLUSIONSHepatic EHE may manifest as nodular lesions with predilection of peripheral subcapsular growth and nodular confluence, together with "halo" sign and " capsular retraction". The peripheral dark rim on a fat-suppression T2-weighted image and slight enhancement at the hepatobiliary phase can help to improve the accuracy of diagnosis and differential diagnosis of this hepatic tumor. MRI is superior to CT imaging to denict their intra-lesional characteristics.

Hemangioendothelioma, Epithelioid ; diagnosis ; diagnostic imaging ; pathology ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Neoplasms, Multiple Primary ; diagnosis ; diagnostic imaging ; pathology ; Physical Examination ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To assess the value of 64-slice CT colonography (CTC) in preoperative TN staging of colorectal carcinomas. Methods One hundred and sixty-eight patients with suspected colorectal neoplasm underwent 64-slice spiral CTC after bowel cleaning and rectal air insufflating, among them 91 patients were proved with surgical pathology and enrolled into this study, and CTC images were reviewed separately by two experienced radiologists for preoperative TN staging of the tumors. Results For CTC evaluation of T staging, the sensitivity, specificity and accuracy were 98.57% (69/70), 85.00% (17/20) and 92.31% (84/91), respectively. The sensitivity, specificity and accuracy of CTC N staging were 87.80% (36/41), 96.00% (48/50) and 82.42% (75/91), respectively. Conclusion 64-slice spiral CTC plays a significant role in the preoperative TN staging of colorectal carcinoma.

Objective To assess the value of 64-slice CT colonography (CTC) in diagnosing colorectal neoplasms. Methods One hundred and thirty-two patients with suspected colorectal neoplasm underwent 64-slice spiral CT after bowel cleaning and rectal air insufflating, double contrast barium enema (DCBE) and colonoscopy. CT data were transmitted to the workstation and was performed respectively. All images were separately evaluated by two experienced radiologists. The sensitivity, specificity and accuracy of the CTC and DCBE were evaluated and compared with that of colonoscopy or surgical biopsy. Results The sensitivity, specificity and accuracy of CTC was 96.49%, 90.91% and 95.59%, of DCBE was 91.23%, 72.73% and 88.24% (χ~2=0.566, P=0.319). In neoplasms with diameter ≤5.0 mm, the sensitivity, specificity and accuracy of CTC was 80.95%, 86.96% and 84.09%, of DCBE was 57.14%, 69.56% and 63.64% (χ~2=0.679, P=0.422). In neoplasms with diameter of 5.1-9.9 mm, the sensitivity, specificity and accuracy of CTC was 91.67%, 100% and 94.12%, of DCBE was 75.00%, 80.00% and 76.47% (χ~2=0.631,P=0.374). The sensitivity, specificity and accuracy of both CTC and DCBE for detecting neoplasms with diameter ≥10.0 mm was 100%. Conclusion CTC is valuable in detecting colorectal neoplasm as a noninvasive method.