1.Diagnosis and differential diagnosis of cervical lymph node diseases
China Oncology 2017;27(6):415-420
Most of the cervical lymph node metastasis comes from thyroid cancer and squamous cell carcinoma of different regions of the neck. Origin of the primary cancer could be general speculated based on thefirst metastatic station site. The metastatic lymph nodes of squamous cell carcinoma and thyroid carcinoma have their own characteristics. These metastatic lymph nodes need to be differentiated from lymph node inflammatory changes, tuberculosis, lymphoma, Castleman's disease, and soft tissue tumors.
2.Advanced applications of digital mammography imaging
China Oncology 2013;(8):609-612
Digital breast tomosynthesis is a 3D radiographic technique that obtains information from a few projection images, these images are the reconstructed into a set of images. Breast tomosynthesis could be used in breast cancer screening and diagnosis. This technique reduced the call-back rate in breast cancer screening, and increased the sensitivity and accuracy in detection of the lesion. Contrast-enhanced dual-energy digital mammography processes low-energy image and subtraction image from high and low energy images, iodine enhancement was performed, which could better depict the enhanced tumor. This technique was only used to diagnosis, it could improve the sensitivity of breast cancer detection compared to the conventional mammography and combined the mammography and ultrasound. Contrast-enhanced dual-energy digital mammography had a higher specificity for detecting index cancer than did enhanced MR imaging, and sensitivity was equal.
3.To Improve the Understanding of Mammographic Features of Breast Infiltrating Lobular Carcinoma (An Analysis of 28 Cases)
Journal of Practical Radiology 2001;0(10):-
Objective To improve understanding of the varied, especially atypical mammographic appearances of breast infiltrating lobular carcinoma(ILC). Methods We retrospectively studied 28 ILC (27 patients) mammographic appearances and correlated with the clinical examination, ultrasonographic(US) findings.Results ①The most frequent mammographic finding was an uncalcified mass (13), followed by a mass with calcifications (5), architecture distortion was seen in 4 lesions, two lesions appeared indistinct calcifications. Pleomorphic microcalcifications, focal asymmetric density were 1 respectively, negative mammogram was in two cases. ②Eighteen lesions appeared a mass with or without calcifications on mammogram. Of them, 5 lesions appeared irregular shape. The mass with indistinct margins and spiculated borders were 9 and 6 lesions respectively. ③Seven lesions appeared subtle features, such as architecture distortion (4), indistinct calcifications (2) and focal asymmertric density (1). ④The sensitivity of mammographic detection was 86%(24/28), clinical examination was 64%(18/28), US was 85% (17/20). The sensitivity could be improved to 96%(27/28) by the use of integrated mammography, US, and clinical examination.Conclusion The irregular mass with indistinct or spiculated margins is the predominant mammographic sign in ILC. Atypical features, such as architectural distortion etc are frequently findings. The combination of mammography, ultrasonography and clinical examination is effective to detect ILC.
4.Application and evaluation of magnetic resonance imaging in the multidisciplinary treatment of breast cancer
China Oncology 2013;(8):613-617
It has been shown that MR imaging of breast is superior to conventional mammography and ultrasonography on early diagnosis and cancer staging on breast cancer due to MRI’s high soft-tissue contrast and no radiation. The concept of multidisciplinary treatment of breast cancer has been increasingly accepted in clinical practice of breast cancer care. Investigation of breast MRI on cancer staging, selecting conservative therapy, detecting the primary malignant of patients presenting as axillary metastases, evaluating residual disease after neoadjuvant chemotherapy(NAC), predicting response in the early phase of treatment as well as monitoring recurrence during follow-up has been carried out along with its board clinical application. The advantages of breast MRI in mapping the disease accurately provide measures to select appropriate use of variable treatments.
5.CT and MRI evaluation of peripheral primitive neuroectodermal tumors
Qin XIAO ; Yajia GU ; Tianxi YANG
China Oncology 1998;0(04):-
Purpose:We present the imaging and pathological features of pPNET tumor in six patients,to add to the knowledge of this tumor. Methods:Retrospective analysis of six pPNETs integrated with data of radiography and pathology. Results:The CT appearance of the tumor arising in soft tissue showed a large,ill-defined,non-calcified mass and heterogeneous appearance with hypodense cystic areas. The tumors demonstrated heterogeneous contrast enhancement. The pPNET arising in bone demonstrated extensive lytic lesion with large soft tissue mass,no newly-born bone and demonstrated heterogeneous contrast enhancement. MRI in SE sequences on T 1 W demonstrated homogeneous intensity for muscle and showed enhancement pattern of multiple internal septa and envelope. On T 2 W image,the tumors were heterogeneous with hyperintense signal. Conclusions:The study of clinic and radiology on pPENT does not show specificity. CT and MRI findings on pPENT can provide more information of it's internal structure,involved area,adjacent vascular and nervous structures. CT and MRI can also be useful in detection of recurrent and metastatic disease and very useful in preoperative staging,and in the planning of the surgical appproach.
6.Mammographic and MRI Appearances of Primary Non-Hodgkin's Lymphoma of Breast
Wanyi SHAO ; Yajia GU ; Feng HE
Journal of Practical Radiology 2001;0(10):-
Objective To discuss the features of MRI and molybdenum target X-ray in mammary primary non-Hodgkin's lymphoma.Methods 3 cases of mammary primary non-Hodgkin's lymphoma were studied.The features of MRI and molybdenum target X-ray werecollected and analyzed(all 3 cases had molybdenum target X-ray in MLO site and CC site,one had MRI image).Results All 3 caseslesions were in single side,one case had two lesions in one side.The diameter of all the lesions were more than 3cm.The lesion presented as iso-or slight hyperdensity shadow,and related to breast tissue and density was hemogeneous.The tumor was irregular but no bristle andcalcification.There was no skin and nipple involved in superficial of mammary gland.In T_1WI showed even low signal.In T_2WI showedeven little high or equal signal.Intensity was hemogeneous and obvious.The curve of time-signal intensity was platform pattern.Conclusion The features of MRI and molybdenum target X-ray in mammary primary non-Hodgkin's lymphoma are characteristic and helpful for deciding correct therapy plan.
7.Mammographic features of breast mucinous carcinoma: mammographic-pathologic correlation
Yajia GU ; Jiuhua WANG ; Tingqiu ZHANG
Chinese Journal of Radiology 2000;0(11):-
0.05,respectively. Chi-square test, Fisher′s exact method). Conclusion The mammographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high volume of mucin is a mass with microlobulated margins. Pure type of carcinomas with small volume of mucin and mixed type carcinomas have more aggressive imaging characteristics.
8.A study on clinical value of CT features of tracheoesophageal groove lymph node metastasis of thoracic esophageal carcinoma
Yajia GU ; Jiuhua WANG ; Jiaqing XIANG ; Longfei MA
Chinese Journal of Radiology 2001;0(02):-
Objective To evaluate the clinical value of CT scan in the diagnosis of tracheoesophageal groove lymph node (TEGLN) metastasis of thoracic esophageal carcinoma. Methods Forty-six patients with thoracic esophageal carcinoma underwent esophagectomy with three-field dissection (3FD) of the cervical, mediastinal, and abdominal lymph nodes. CT findings of TEGLN were compared with that of pathological findings. Results Among the 46 patients who underwent esophagectomy with 3FD, 14 (30%) were found to have TEGLN metastases. Of the 277 TEGLNs excised by operation, 16 were found to have metastases. Primary sites of the thoracic esophageal carcinoma with TEGLN metastasis in upper, middle, or lower portion were 66.67%, 22.86%, and 40%, respectively. The difference between each portion was not statistically significant. The thoracic esophageal carcinoma with TEGLN metastasis in T 1, T 2, T 3 and T 4 staging were 50.00%, 25.00%, 28.57%, and 100.00%, respectively. There was no statistically significant difference between each T staging. 18 TEGLNs were found in CT scans. The average diameter of them was 1cm (0.3~2.5 cm). Sensitivity and specificity of CT examination were 87.50% and 98.47%, respectively. Positive predict value and negative predict value were 77.78% and 99.23%, respectively. Conclusion In patient with thoracic esophageal carcinoma, nodules appeared in tracheoesophageal groove could be diagnosed as lymph nodal metastases. Low cervical and mediastinal CT scan should be a conventional examination, and it was the basis of the radiation therapy plan. Dissection of TEGLN was very important for patient of thoracic esophageal carcinoma, but if bilateral tracheoesophageal grooves were negative in CT scans, and bilateral internal jugular chain and bilateral superclavicular lymph node were both negative in clinical examination. 3FD dissection, which could increase the rate of operative complication, was not conventionally used.
9.The comparison of mammographic and pathologic features in ductal carcinoma in situ
Yajia GU ; Jiuhua WANG ; Xiaoyu TU ; Tingqiu ZHANG
Chinese Journal of Radiology 2001;0(03):-
Objective To analyze the mammographic features of ductal carcinoma in situ (DCIS) of the breast and the correlation between the mammographic and pathologic findings, and try to provide clinical criteria for selecting patients for appropriate local treatment. Methods A retrospective study was performed to analyze the mammographic features and to correlate the mammographic and pathologic findings in 29 consecutive cases of DCIS including 8 cases of DCIS associated with small invasive foci. Results (1)There were various features in mammograms of DCIS, including cluster microcalcifications (20 cases), ill defined mass with calcifications (3 cases), mass (4 cases), nipple retraction associated with big ductal dilatation (1 case), and normal mammogram (1 case). (2)The shape of the calcification cluster distributed as V shaped in 7 cases, round in 8 cases, irregular in 5 cases, and scattered as many small areas in one quadrant in 3 cases.(3)1 lesion appeared as strip from the deep aspect of the breast to the nipple, and 3 masses were round. (4)The comedo subtype (7/9) and the high grade nuclei of DCIS (6/9), correlating with poor prognosis, were more likely to be accompanied by linear and branching calcification. Noncomedo DCIS (11/12) and low grade nuclei (11/12) were more likely to be associated with granular and punctate calcification when microcalcification were seen on mammogram. There was statistically significant difference between the two groups with P =0.002 and P =0.009 respectively (Chi square test, Fisher′s exact method). Conclusion The mammographic findings of DCIS were characteristic. They were closely associated with the pathologic features that were correlated with the biomolecular findings. To some extent, the choice of treatment could be based on these mammographic findings.
10.MRI diagnosis of aggressive fibromatosis
Yunyan ZHANG ; Yajia GU ; Weijun PENG ; Jian WANG
Chinese Journal of Radiology 2011;45(12):1155-1158
ObjectiveTo analyze the MRI features of aggressive fibromatosis (AF) in order to improve its diagnostic accuracy.Method The clinical files and MRI appearances of 66 AF patients (primary 19 cases,recurrent 47 cases) were reviewed and compared with the postoperative pathological findings.ResultsThe median age of all patients was 31 years( range,11—60 years) with a male-to-female sex ratio of 1 ∶ 3.4.Eighty tumors were discovered.There were 5 superficial fibromatosis and 75 deep fibromatosis in which 2 lesions were intraabdominal,6 lesions in the abdominal wall and 67 lesions extraabdominal.The average long diameter of all lesions was ( 8.7 ± 5.4 ) cm,of superficial lesions ( 5.7 ±2.8) cm,of deep lesions ( 8.9 ± 5.5 ) cm.Of the 80 tumors,79 were displayed as space-occupying intramuscular lesions; 47(58.8% ) were ovoid or lobulated and 22( 27.5% ) were infiltrative in shape; 48 (60%) lesions had a well-defined margin,of which 4 formed a pseudocapsule as they enlarged by compressing normal tissue.To compare with the muscle signal intensity on MRI,75 lesions demonstrated isointensity,mild hyperintensity or hypointensity on T1 WI,heterogeneous high intensity on T2 WI,and avid heterogeneous enhancement after contrast administration.There was no necrosis or surrounding edema in all lesions.Tumors destroyed bone in 2 cases.ConclusionAggressive fibromatosis has characteristic features on MRI,and MRI is valuable in diagnosising AF and evaluating the extend of lesion and involvement of adjacent structures.