Purpose: To determine breast carcinoma detection rate of a new mammographic computer-aided system (CAD) in order to assess its clinical usefulness. Methods: 467 cases of breast carcinoma proved by surgery and pathology were retrospectively analyzed. All the mammograms of the cases were reviewed by two radiologists working as a team and then analyzed by the CAD-system. The sensitivity for breast carcinoma detection (masses or calcification) was calculated respectively, and the results compared. Results: The sensitivity for breast carcinoma detection by the same radiologists without and with the CAD-system were 80. 94% , 88. 01% , respectively (P

Objective To study the values of HMRS and DTI technology for detecting brain damage in heroin-dependent patients.Methods The routine MRI,HMRS and DTI were performed in 7 heroin abuser8 and 8 healthy volunteers without the history of drug abuse.The regions of interest(ROI) were selected in the gray matter and white matter of prefrontal lobe in HMRS exam,and the ratio of NAA/ Cr、Cho/Cr and Cho/NAA were measured respectively.For the DTI,six ROIs were selected,and the values of fractional anisotropy(FA)and ADC were calculated respectively.The independent samples t test was used for the statistics.Results No abnormality was found in the routine MRI.The ratio of NAA/Cr decreased in the prefrontal lobe.the values were 1.40±0.16 in gray matter and 1.72±0.41 in white matter 0f the drug group.1.57±0.09 and 2.08±0.21 in the control group on HMRS examiation.The differenee between the two groups had statistical significance(t=2.183,2.190,P<0.05)On DTI examination,the values of FA decreased in GCC,SCC and AIC,each was 0.70±0.04,0.76±0.41,0.55±0.03 in drug group,and 0.76±0.03,0.82±0.03,0.64±0.03 in controlgroup.The difference betweenthetwo groups had statistical significance(t=3.830,3.713,5.555,P<0.05).The value8 of ADC increased in SCC,PIC and EC in drug group,each Was(8.18±0.48)×10-4,(7.54±0.22)×10-4,(7.72±0.30)× 10-4and(7.50±0.26)×10-4,(7.154-0.20)×10-4,(7.19±0.39)×10-4mm2/s in control group respectively.The difference between tlle two groups had statistical significance(t=3.477,3.507,2.895, P<0.05).Conclusion The early abnormalities of the brain in heroin-induced patients can be found combining HMRS and DRI.

Objective To evaluate MRI in diagnosing brachial plexus preganglionic injury.Methods Twenty cases with brachial plexus preganglionic injury underwent M R scanning before operation.MR imaging was obtained by GE Signa EXCITE 1.5 T scanner.The scanning sequences included SE T1 WI,FSE T2 WI,T2 WI STIR and 3D Fast imaging employing steady state with phase cycled(3D-FIESTA-c).All the patients had exploration of the supraclavicular plexus and electrophysiology examination. And the accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus iniury were calculated with the standards of surgical and EMG results.Results Among the 73 pairs of i,jured roots.MR imaging detected the abnormalities in 63 pairs.The accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 86.5/(83/96),86.3/(63/73).87.0/(20/23),respectively.The direct signs of brachial plexus preganglionic injury included (1) lack or mutilation of netwe root in 54 pairs (85.7/),(2)coarsening,bending,stiff course and unable to be traced to the intervertebral foramen continuously in 9 pairs (14.3/).The indirect signs included (1)cystic cerebrospinal fluid gathering in the vertebral canal,posttraumatic spinal meningocele in 46 pairs (73.0/),(2)abnormal shape of nerve sleeve in 13 pairs(20.6/),(3)displacement and deformity of spinal cord in 50 pairs(79.4/),(4)abnormal signal of paravertebral muscles in 1 9 patients.Conclusion MRI can distinctly show the nerve rootlets within the vertebral canal,so it is helpful in making a correct diagnosis of brachial plexus preganglionic injuries.

Objective To evaluate the MRI application in the common non-traumatic brachial plexopathies.Methods Twenty-seven patients with non-traumatic brachial plexopathies were retrospectively analyzed,which consisted of 10 males and 17 females with age range from 22 to 70 years old.Among the patients,2 were neurofibromatosis,8 were schwannoma,3 were metastases,2 were radiation plexopathy,1 was multifocal motor neuropathy (MMN),and 11 were typical thoracic outlet syndrome (TOS).Before treatment,all patients underwent MRI of brachial plexus,in which 8 patients underwent Gd-DTPA enhanced MRI.Results In 2 cases of neurofibromatosis,the tumors appeared as fusiform,bead-like masses,growing along the course of brachial plexus with involvement of rootlets in vertebral canal,and iso-to little hypointensity on T1WI,inhomogeneous hyperintensity on T2WI and inhomogeneously enhanced.Schwannoma of 8 cases displayed as fusiform mass,eccentric to the original nerve with sharply defined edge,and hypointensity or inhomogeneous hyperintensity on T1WI,inhomogeneous hyperintensity on T2WI with cystic necrosis in 3 cases which was inhomogeneously enhanced.Two of the 3 cases of metastases manifested as multiple masses besides brachial plexus,the other one appeared as widespread lesion infiltrating brachial plexus and surrounding structures.Two cases of radiation plexopathy displayed as diffused thickened nerves,with increased signal intensity on short time inversion recovery (STIR),clear structure and no mass surrounding the plexus.One case of MMN showed thickened nerves with increased signal intensity on STIR.Eleven cases of typical TOS manifested as arched elevation of C8,T1 and inferior trunk,with thickened nerves and increased signal intensity on STIR.Elevated subclavian artery could be seen in 8 cases.And in one case of TOS,a mass in the end of cervical rib compressed the local brachial plexus.Conclusions MRI can clearly show the location,involved scope and the relationship with adjacent structures.So MRI can provide reliable information for clinical diagnosis and treatment.

Objective To verify the accuracy of blood oxygenation level dependent (BOLD)-based activation using electrocortical stimulation mapping (ESM) and explore the value of language fMRI in the navigating operation of neurosurgery. Methods In 8 cases with brain tumors,BOLD-fMRI examinations were done before the operations. Under the state of awake anesthesia,the patients were aroused and ESM was conducted. Point-to-point comparison between the BOLD signal activations and the ESM was carried out under the surveillance of the neuro-navigation technology. In order to observe the sensibility and specificity of BOLD activations, the location of BOLD activations and the point of ESM was compared to calculate the stimulating positive points inside the regions of BOLD signals(real positive), outside BOLD regions(pseudo-negative), the stimulating negative points inside the regions of BOLD signals(pseudo-positive), and outside BOLD region(real negative). Two kinds of criteria for assessment were used. One was that the positive stimulating points were located in BOLD regions, and the other was that the positive stimulating points were located within 1 cm around the range of BOLD regions. Removal of the lesions were conducted with the tissue 1 cm around the language region preserved, and the cortex inside 0.5-1.0 cm distance from the positive points were retained. Results Of the 8 cases, only 6 finished the tasks. Among them, 3 cases were with astrocytoma of grade 2,2 were with astrocytoma of grade 3, and one with glioblastoma. The total number of stimulating points was 48, among which the positive points were 11. When the first criteria was applied, the sensitivity was 72.7% (8/11), and the specificity was 81.8% (30/37). When the second criteria was applied, the sensitivity was 82.0% (9/11),and the specificity was 75.6% (28/37). Follow-up after operation showed no aphasia occurred. Conclusions BOLD-fMRI had a high sensitivity and specificity in displaying the language regions. But due to the great variation of brain language area among the people, we need more studies of large sample to obtain enough experience before it can be used clinically.

Objective To assess the clinical features and associated factors of interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Clinical data were retrospectively analyzed on 206 patients with DM collected at the Department of Dermatology,Huashan Hospital,Fudan University in the past 6 years.Chi-square test and t test were performed for statistical analysis.Results The prevalence of ILD was 49.03％ in the 206 patients with DM.Heliotrope rash on the upper eyelids,Gottron's sign (papules),arthralgia,and cough were correlated with the incidence of ILD in DM patients (all P ＜ 0.05),and of these factors,the prevalence of artharalgia and cough were positively correlated with the incidence of ILD,while the presence of Gottron's papules was negatively correlated.The patients with DM and ILD showed a higher prevalence of abnormal serum levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH) and anti-Jo-1 antibodies,as well as with a poorer pulmonary function,compared with those suffering from DM only (all P ＜0.05).Characteristic imaging findings on computed tomography (CT) scan in patients with DM and ILD included linear opacity (57.4％),high-density patchy opacity (31.7％),reticular opacity (16.8％) and even ground glass-like opacity (13.8％),usually at the bottom or apex of the lungs.Conclusions In patients with DM,the prevalence of artharalgia and cough is positively correlated,whereas the presence of Gottron's papules is negatively correlated,with the incidence of ILD.Characteristic imaging findings on CT scan in patients with DM and ILD are linear opacity,high-density patchy opacity,reticular opacity and ground glass-like opacity at the bottom and apex of lungs.

Objective To study the imaging features of the ventricular meningioma, in order to improve the understanding knowledge. Methods Compared with operative and pathological findings,the CT and MRI features of ventricular meningioma were analyzed in 22 patients (8 males and 14 females,range from 17~72 years old with average age 45 years).21 cases were examined by MRI(17 with enhanced scan),11 cases by CT(4 with enhanced scan).Results The ventricular meningioma were mostly fibrous type. Mostly, the locations were in the trigone of the lateral ventricle with regular shape. On imaging, the most were parenchymatous with markedly enhancement. Calcification may be found, but cystic changes and hemorrhage were very rare.Conclusion The ventricular meningiomas have characteristic imaging features. CT and MRI are valuable in diagnosis, especially MRI.

Objective To analyses the CT misdiagnostic causes of gallbladder carcinoma, in order to improve the diagnostic rate.Methods Fourty-three patients with the gallbladder carcinoma proved histologically were examined by computed tomography (CT), twenty-three of them were misdiagnosed.The misdiagnostic causes were analysed and compared CT images with operation.Results In the cases of misdiagnosis they were diagnosed as acute or chronic cholecystitis in 5; polyp in 1; bile duct carcinoma in porta hepatis in 2; cholangiocarcinoma in 1; neoplasm of distal part of common bile duct or ampulla in 3; carcinoma of head of pancreas in 5;cholangitis in 1; jaundice of obstruction in 2;tumefaction of gallbladder in 2;carcinoma of colon in 1. Conclusion To be aware of CT characters of gallbladder carcinoma and the way of metastasis is useful to avoid misdiagnosis of the gallbladder carcinoma and to improve the diagnostic rate.

Objectives To examine the clinical usefulness of magnetic resonance spectroscopy (MRS) on assessment of vascular dementia (VD) in patients with stroke; the relationships between metabolic changes of brain and clinical symptom improvements after giving rivastigmine in these patients.Methods 20 stroke patients without VD, male 17, female 3, with a mean age of (71.7?4.7) years old; 23 stroke patients with VD, male 20, female 3, a mean age of (72.9?5.1) years old; 20 normal volunteers were studied, a mean age of (70.9?4.8) years old. MRS was performed in all these patients. The patients with VD were prescribed rivastigmine hydrogen tartrate ("Exelon", Norvatis), and given MRS assessment half a year later.Results The patients with VD had a significantly lower N-acetyl aspartate/Creatine (NAA/Cr) ratio (mean?SD: left: 0.57?0.30; right: 0.66?0.29) and higher Choline/Creatine (Cho/Cr) ratio (mean?SD: left: 1.79?0.52; right: 1.97?0.44) in bilateral temporal hippocampus area, compared to those without VD (mean?SD: NAA/Cr: left, 0.91?0.31; right, 0.87?0.27, P

Objective To explore the relationship between structure and function in the diseases of posterior visual pathways as well as the anatomic mechanism of the abnormal visual responses.Methods Eleven cases of diseases of posterior visual pathways(3 gliomas,4 meningiomas,3 metastasis,1 stroke) involving either cortical or subcortical visual pathways were investigated by combining fMRI and DTI.fMRI was performed by using flashing checkerboard at 8 Hz.For imaging processing,fMRI analysis was performed with SPM99,and DTI and tractography with DTVⅡ.Fractional anisotropy(FA) of optic radiations and activated volume(VOXELs) of primary visual cortices(V1 and V2) were measured and analyzed at the affected side and the contralateral side.Relative FA(rFA) and relative activated volume(rVOXELs) were also calculated.3D tractography of optic radiations was performed successfully in 11 patients.Results In the patients with brain tumors,FA values in the affected side of optic radiations were significantly different with the contralateral side(P