[Objective]To explore the MRI features of the mucinous breast carcinoma and the correlation with biological prognos?tic factors.[Methods]MRI features of 35 pure and 15 mixed mucinous carcinomas were retrospectively analyzed. MR images were reviewed for shape,margin,the signal intensity,enhancement patterns of tumors and DWI features. All the patients were detected by immunohistochemical staining with expression of ER,PR,CerbB-2,Ki-67 and Her-2. Correlations between the pure and mixed mucinous breast carcinoma and prognostic factors were analyzed.[Results]16 oval masses(16/35,45.7%)and 10 circular masses (10/35,28.6%)were found in 35 pure mucinous breast carcinomas with clear boundary(26/35,74.3%)and lobulated shape(31/35,88.6%);9 irregular masses(9/15,60%)were found in mixed mucinous breast carcinomas with unclear boundary(13/15, 86.7%). Very high signal intensity on T2-weighted images was found in 33 pure mucinous carcinomas(33/35,94.3%)and 11 mixed mucinous carcinomas showed mixed signal intensity(11/15,73.3%). Early enhancement rate was(114.7 ± 9.1)% for pure muci?nous carcinomas and(165.6 ± 14.3)%for mixed mucinous carcinomas. 28 pure mucinous tumors demonstrated persistent enhancing pattern on time-signal intensity curve ,7 pure mucinous tumors demonstrated plateau pattern and 7 mixed mucinous carcinomas showed plateau pattern and washout pattern respectively. Mean ADC value was(1.91 ± 0.06)×10-3 mm2/s for pure mucinous carcino?mas and(1.13±0.08)×10-3mm2/s for mixed mucinous carcinomas. There was significant difference with morphology,boundary,T2WI signal,early enhancement rate,time-signal intensity curve,ADC value between pure and mixed mucinous breast carcinoma(P <0.05). There was significant difference between pure and mixed mucinous breast carcinoma with Her-2 and Ki-67 expression(P <0.05).[Conclusion]MRI could identify PMBC and MMBC from the shape,the signal intensity,dynamic enhancement and ADC val?ue,and PMBC had distinctive MRI features. The prognosis of MMBC is worse than that of PMBC form correlation between biological prognostic factors and mucinous breast carcinoma.

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.

ObjectiveTo investigate the clinical value of 320-slice spiral CT in diagnosis of metastatic liver cancer with atypical CT manifestations.MethodsClinical data of 62 patients with metastatic liver cancer with atypical CT manifestations who were conifrmed by the pathological examination and underwent 320-slice CT plain scan and enhanced scan in the First People's Hospital of Guangzhou from August 2010 to August 2014 were studied retrospectively. Of the 62 patients, 45 were males and 17 were females with the age ranging from 37 to 83 years old and the median of 63 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The imaging characteristics of the lesions by spiral CT plain scan and enhanced scan were observed, including density, number, boundary and enhancement pattern of the lesions.ResultsOn CT plain scan of the 62 cases, 94% (58/62) displayed low or slightly low density and 6% (4/62) displayed mixed high and low density, 77% (48/62) were with multiple lesions and 23% (14/62) were with single lesion; 79% (49/62) were with obscure boundary and 21%(13/62)were with well-deifned boundary. On CT enhanced scan, 50% (31/62) were with progressive enhancement, 21% (13/62) were without obvious enhancement, 11% (7/62) were with wreath-like edge enhancement, 5% (3/62) were with fast in fast out enhancement and 13% (8/62) were with multiple patterns enhancement.Conclusions320-slice dynamic contrast enhanced spiral CT may better relfect the histological and blood supply characteristics of metastatic liver cancer with atypical imaging manifestations and provide more accurate imaging evidences for the formulation of clinical therapeutic regimen.

Objective To evaluate the effect of thoracic paravertebral block combined with general anesthesia on postoperative cognitive dysfunction (POCD) in elderly patients undergoing pulmonary lobecto-my. Methods A total of 120 elderly patients of both sexes, aged 65-81 yr, of American Society of Anes-thesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰor Ⅱ, were divided into 3 groups (n＝40 each) using a random number table method: anesthesia group (group GA), epidural block combined with general anesthesia group (group EG), and paravertebral block combined with general anes-thesia group (group PG). In group PG, paravertebral block was performed under ultrasound guidance, 0. 25% ropivacaine 20 ml was injected after the paravertebral catheter was placed, and anesthesia was in-duced after confirming the plane of block. In group EG, epidural block was performed with 2% lidocaine 3 ml after epidural puncture was successfully performed at L6,7interspace, epidural 0. 375% ropivacaine 8-15 ml was intermittently injected, and anesthesia was induced after confirming the height of block. Anes- thesia was induced with IV midazolam 0. 05-0. 10 mg∕kg, etomidate 0. 3 mg∕kg, sufentanil 0. 4 μg∕kg and rocuronium 0. 6 mg∕kg. The patients were tracheally intubated and mechanically ventilated. The develop-ment of POCD was recorded at 1 day before operation and 7 days after operation. Blood samples were col-lected from the internal jugular vein before anesthesia, at 15 min after skin incision and at 7 days after oper-ation for determination of serum adiponectin ( ADP) and S-100β protein concentrations. Results Com-pared with group GA, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were decreased and serum ADP concentrations were increased at 15 min after skin incision and 7 days after operation in PG and EG groups ( P＜0. 05). Compared with group EG, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were increased and serum ADP concentrations were decreased at 15 min after skin incision and 7 days after operation in group PG (P＜0. 05). Conclusion Thoracic paravertebral block combined with general anesthesia induces better efficacy in decreasing the occurrence of POCD than general anesthesia alone or combination of epidural block and general anesthesia in elderly patients undergoing pulmonary lobectomy, which is related to the decreased concentrations of blood ADP in elderly patients undergoing pulmonary lobectomy.