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.

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.

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.

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.

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.

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.

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.

Objective To explore the efficacy of high-resolution MRI in the prediction of tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.Methods The clinical data of 108 patients with T3 rectal cancer who were admitted to Shanghai Cancer Center of Fudan University from 2010 to 2012 were retrospectively analyzed.The TNM stage of tumor,extramural depth of tumor invasion (mrT3 stage),involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor were the main items of evaluation using the high-resolution MRI.A total of 108 patients underwent surgical resection of tumor after neoadjuvant chemoradiation therapy.The tumor complete response after neoadjuvant chemoradiation therapy was evaluated by tumor node metastasis (TNM) stage and tumor regression grade (TRG).The categorical data and multivariate analysis were done by the single factor analysis of variance (ANOVA) and Logistic regression analysis.Results The positive response rate of the T3a,T3b and T3c in the patients were 61.5％ (16/26),36.9％ (24/65) and 11.8％ (2/17) after neoadjuvant chemoradiation therapy,respectively.The mrT3,mrN and tumor diameter were the potential factors affecting response of neoadjuvant chemoradiation therapy by the univariate analysis of pathological restaging (x2 =50.474,30.985,8.318,P ＜ 0.05).The mrT3 was an independent risk factor affecting response of neoadjuvant chemoradiation therapy by the multivariate analysis of pathological restaging (OR =4.473,95 ％ confidence interval:2.003-9.991,P ＜ 0.05).There was no significant difference between the mrT3 stage,N stage,involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor before therapy and the response after neoadjuvant chemoradiation therapy based on the tumor regression grade(TRG) (x2 =6.264,6.159,2.949,2.189,6.335,P ＞ 0.05).Conclusion The mrT3 in patients undergoing high-resolution MRI before neoadjuvant chemoradiation therapy could predict the tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.

Background and purpose:Neoadjuvant chemotherapy to breast cancer has become a mature treat-ment method. The purpose of this study was to evaluate the dynamic contrast-enhanced MRI in assessing the response to neoadjuvant chemotherapy (NAC).Methods:Twenty-four female patients with breast carcinoma (24 were all inva-sive ductal carcinoma) underwent dynamic contrast-enhanced MRI (DCE-MRI) before, after the second and ifnal cycle of NAC. For each patient and each MRI examination, the maximum diameter of tumor, volume transfer constant (Ktrans), exchange rate constant (Kep), and extravascular extracellular volume fraction (Ve) were compared. According to the method of response evaluation criteria in solid tumor (RECIST), the results of neoadjuvant chemotherapy were divided into responder and non-responder.Results:All 24 patients were unilateral and single breast cancer; there were 17 cases of responders and 7 cases of non-responders according to RECIST criteria. For 17 cases of responders, both the average values ofKtrans andKepwere signiifcantly descended after neoadjuvant chemotherapy (allP<0.05).Conclusion:The quantitative parameters ofKtrans andKep can evaluate objectively and veridically the response to neoadjuvant chemother-apy for breast cancer in dynamic contrast-enhanced MRI.

Objective To evaluate MR and CT imagings of desmoplastic fibroblastoma(DF) and aggressive fibromatosis(AF) in neck and shoulder girdle, and to emphasis upon the MRI findings with pathological correlation. Methods MR and CT appearances of DFs(4 cases) and AFS(3 cases) confirmed by surgical and pathologic findings were retrospective analysed, which were correlated to the pathologic features. Four cases of DF were male patients, with a median age at 48 years. Two cases of AF were female (20,29 years respectively), and another AF patient was male (79 years). Results (1) Four DFs were round mass located in the intermuscle space of neck, and the margins were mostly well-circumscribed. Envelope was seen in one lesion on MRI. On unenhanced CT, the masses showed homogeneous low attenuation (2 cases) or slightly low attenuation with several heterogeneous areas in it (1 cases). Enhancement was not obvious on post-contrast CT images. MRI studies were done in two patients. Signal intensity (SI) on MR was homogeneous and heterogeneous one lesion respectively on unenhanced T_1-weighted images. Mixed SI as low or high SI nodes within isointense compared with muscle on T_2-weighted images. No evident enhancing was noted after administration of gadopentetate dimeglumine. (2) All three lesions of aggressive fibromatosis arose from musculoaponeurotic structures. The masses were irregular margin and appeared elongated, which oriented in the direction of the muscle bundle. On unenhanced CT examination, the masses had poorly defined and isodense relative to adjacent musculature (2 cases). On T_1-weighted images, three masses consisted of poor margination and isointensity relative to adjacent muscle. On T_2-weighted images, two lesions were heterogeneity of signal, which predominantly slightly high in SI with strip- or node-shape low SI, and one lesion had homogeneous high SI. On post-contrast T_1-weighted images, all lesions showed marked enhancement, heterogeneity of signal and irregular margin appeared distinctly. Of them, two masses had claw-shape invasive margin. Conclusion Both DF and AF, the age range of affected persons different, were fibroblastic origin soft-tissue neoplasms. The distinct imaging characteristics of these two disorders were related to their different [JP3]pathologic features. Concerning the effect of diagnose and differential diagnose, MRI was predominance over CT. [JP]