OBJECTIVE: To optimize the MR imaging protocol for coronary arterial wall depiction in vitro and characterize the coronary atherosclerotic plaques. MATERIALS AND METHODS: MRI examination was prospectively performed in ten porcine hearts in order to optimize the MR imaging protocol. Various surface coils were used for coronary arterial wall imaging with the same parameters. Then, the image parameters were further optimized for high-resolution coronary wall imaging. The signal-noise ratio (SNR) and contrast-noise ratio (CNR) of images were measured. Finally, 8 human cadaver hearts with coronary atherosclerotic plaques were prospectively performed with MRI examination using optimized protocol in order to characterize the coronary atherosclerotic plaques. RESULTS: The SNR and CNR of MR image with temporomandibular coil were the highest of various surface coils. High-resolution and high SNR and CNR for ex vivo coronary artery wall depiction can be achieved using temporomandibular coil with 512 x 512 in matrix. Compared with histopathology, the sensitivity and specificity of MRI for identifying advanced plaques were: type IV-V (lipid, necrosis, fibrosis), 94% and 95%; type VI (hemorrhage), 100% and 98%; type VII (calcification), 91% and 100%; and type VIII (fibrosis without lipid core), 100% and 98%, respectively. CONCLUSION: Temporomandibular coil appears to be dramatically superior to eight-channel head coil and knee coil for ex vivo coronary artery wall imaging, providing higher spatial resolution and improved the SNR. Ex vivo high-resolution MRI has capability to distinguish human coronary atherosclerotic plaque compositions and accurately classify advanced plaques.
Aged, 80 and over ; Animals ; Coronary Artery Disease/*diagnosis ; Coronary Vessels/*pathology ; Diagnosis, Differential ; Disease Models, Animal ; Humans ; *Image Enhancement ; Magnetic Resonance Imaging/*methods ; Male ; Plaque, Atherosclerotic/*diagnosis ; Prospective Studies ; Sensitivity and Specificity ; Swine

Objective To determine the occurrence and clinical characteristics of ectopic pituitary adenoma (EPA) in China.Methods The study are done by searching systematically and comprehensively on major Chinese and English medical literature databases and conference papers before 2015,which are only limited to collected,summarized,sorted and analyzed EPA cases that reported by Chinese authors in English or Chinese occurred in China.Results ① Among the 86 Chinese articles and 27 English articles related to ectopic pituitary adenoma (EPA) gathered by the author,except for cases that have been confirmed as repeated reports,a total of 73 EPA cases were found.Of 70 cases with complete data,31 were male cases,accounting for 44.29％;39 were female cases,accounting for 55.71％;the ratio is 1:1.3.The frequency of EPA occurrence according to the location of the lesion,from high to low in turn,was sphenoid sinus (31 cases,42.47％),nasopharynx (7 cases,9.59％),suprasellar region (7 cases,9.59％),clivus (5 cases,6.85％),followed by the third ventricle,sphenoid sinus/clivus,nasal cavity,and the temporal lobe of the brain,with the same incidence of 4.11％.According to the functional properties of EPA,the frequency of different secreting hormones adenoma was PRL-ma(21 cases,28.77％),NF-ma (21 cases,28.77％),ACTH-ma (15 cases,20.55％),GH-ma (10 cases,13.70％),TSH-ma (2 cases,2.74％) and FSH-ma (1 cases.1.37％).Three cases of EPA were uncertain in their property due to lack of information.The incidence of PRL and nonfunctional tumors was the highest,which was different from what was reported in other countries.Among them,one case of EPA was in pineal region and one in parapharyngeal space,which was even more rare and were never reported abroad.(② Except for 3 cases with incomplete medical records,15 out of 70 cases of EPA were accompanied by empty sella,accounting for 21.43％,among which 11 (73.33％) cases involved the sphenoid sinus,and 3 (20％) cases involved clivus.The sphenoid sinus and clivus cases together accounted for 93.33％.(③ 29 out of the 69 cases of EPA with complete record were invasive pituitary adenomas,accounting for 42.03％ and including 1 case of pituitary adenocarcinoma,which accounted for 1.45％.(④ All cases were treated with surgery as the first choice,and some of them were treated with radiotherapy or drug therapy.Conc lusion Ectopic pituitary adenoma is extremely rare.By the end of 2015,the total number of cases reported in China is only 73,which are mostly located in the sphenoid sinus,suprasellar region and nasopharynx.In the functional classification,the most common types are still PRL adenoma and nonfunctional adenoma as in situ pituitary adenoma.42.03％ of EPA adenomas are invasive.Surgical resection of EPA is the first choice and some cases can be treated with radiotherapy and drug therapy.

Objective To evaluate the assistant diagnostic value of S‐Detect artificial intelligence system in differential diagnosis of benign and malignant breast tumors . Methods Clinical data and ultrasound images of 201 patients undergoing breast ultrasound examination in Tongji Hospital from M arch 2018 to M ay 2018 were acquired . Two‐dimensional grayscale and color Doppler ultrasound images ,S‐Detect mode images and elastographic images of 220 breast lesions were analyzed . T he BI‐RADS categories of each lesion were divided into two groups :experienced group and random group .And according to w hether to refer to S‐Detect diagnostic results ,the BI‐RADS categories in experienced group were divided into A 1 group and P1 group .In additional ,the highest and lowest categories of the same tumor in random group were A 2 group ,and the diagnostic results of A 2 group combining with S‐Detect system were belonged to P2 group . T he ROC curves were plotted and the area under the curve ,sensitivity ,specificity or the accuracy of the different groups were compared . Agreements of diagnostic results between different groups were analyzed by Kappa test . Results Out of 220 breast lesions ,181 lesions were benign and 39 lesions were malignant . The S‐Detect artificial intelligence system had a relatively high diagnostic efficiency ,and the sensitivity , specificity and accuracy of S‐Detect classification were 92 .3% ,90 .6% ,90 .9% , respectively . With its assistance ,the specificity and accuracy in the experienced group had an increasing trend ( A 1 group :86 .7% , 88 .6% ; P1 group :91 .2% ,92 .3% ) ,and the diagnostic accuracy in random group was significantly improved ( A2 group :63 .6% －85 .5% ; P2 group :93 .2% －94 .1% ) . Both S‐Detect system and elasticity score helped to improve the efficacy of ultrasound physicians in differential diagnosis of benign and malignant breast lesions . But there were differences in diagnostic performance and assistant diagnostic ability between the two techniques . Conclusions S‐Detect technique contributes to the augment of diagnostic accuracy of ultrasound doctors in identifying breast cancer , improves the quality of random breast ultrasound examinations ,and reduces missed diagnosis and misdiagnosis of breast examinations .