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Differentiation of Non-puerperal Mastitis from Breast Carcinoma with Non-mass-like Enhancement by Texture Analysis of Contrast-enhanced Magnetic Resonance Imaging

Honsum LI ; Qiang ZHANG ; Haikun QI ; Xinlei PAN ; Sheng XIE ; Huijun CHEN

Chinese Journal of Medical Imaging.2017;25(5):354-359. doi:10.3969/j.issn.1005-5185.2017.05.008

Purpose To investigate the feasibility of texture analysis of breast contrastenhanced magnetic resonance imaging in differentiating non-puerperal mastitis and breast carcinoma with non-mass-like enhancement in order to prevent misdiagnosis of nonpuerperal mastitis.Materials and Methods In this retrospective study,the contrastenhanced MRI images of 42 female patients of invasive ductal carcinoma with non-masslike enhancement and 30 female patients of non-puerperal mastitis were analyzed.3234 texture features were generated from manually selected region of interest (ROI) of normal breast tissue and breast lesions.By means of genetic algorithm and linear discriminative analysis,10 texture features were selected based on their stability and accuracy in breast tissue classification.Results With these 10 features,the linear discriminative analysis classifiers had sensitivity of 92.9％ and specificity of 90.0％ in classifying two lesions,and accuracy of 89.6％ in classifying all three types of tissue.The result showed that texture analysis successfully differentiate non-puerperal mastitis and breast carcinoma with nonmass-like enhancement.Conclusion Texture analysis demonstrates the ability of differentiating invasive ductal carcinoma with non-mass-like enhancement,non-puerperal mastitis and normal breast tissue,and provides reliable results for clinical diagnosis.

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Differentiation of Multiple System Atrophy and Parkinson's Disease Using 11C-CFT PET/CT

Hui YANG ; Zhihui SHEN ; Baixuan XU

Chinese Journal of Medical Imaging.2017;25(5):349-353. doi:10.3969/j.issn.1005-5185.2017.05.007

Purpose To investigate the value of 11C-CFT PET/CT dopamine transporter (DAT) imaging in differential diagnosis of multiple system atrophy (MSA) and Parkinson's disease (PD).Materials and Methods The 11C-CFT PET/CT images of clinically confirmed MSA patients (21 cases),PD patients (24 cases) and healthy adults (10 cases as normal control) were analyzed retrospectively.The volume of interest (VOI) were drawn manually,and the DAT binding indexes and asymmetry indexes of different regions of striatum,including caudate and putamen,were calculated.The differences of DAT binding indexes and asymmetry indexes among the above three groups were analyzed.Results Compared with the normal control group,the striatal DAT binding indexes of MSA group or PD group were significantly reduced (P＜0.05).There were no significant differences in DAT binding indexes between the MSA group and the PD group (P＞0.05).Compared with the normal control group,the DAT binding asymmetry indexes were significantly increased in the PD group (P＜0.05),but the indexes showed no significant differences in MSA group (P＞0.05).The DAT asymmetry indexes of caudate and putamen in the PD group were higher than those in the MSA group (P＜0.05).Conclusion 11C-CFT PET/CT imaging can detect the degeneration of dopaminergic neurons in striatum.The number of striatal dopamine transporters declines in both MSA and PD patients,but the asymmetry of striatal dapamine transporter in PD patients is higher than that in MSA patients.11C-CFT PET/CT can differentiate MSA and PD.

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Correlation Between Characteristics of Middle Cerebral Artery Atherosclerotic Plaque and Infarction Pattern

Sheng JIAO ; Yan SONG ; Cheng ZHOU ; Juan HUANG ; Chen ZHANG ; Wei LI

Chinese Journal of Medical Imaging.2017;25(5):344-348. doi:10.3969/j.issn.1005-5185.2017.05.006

Purpose To characterize the middle cerebral artery atherosclerotic plaque and investigate its relationship with infarction patterns by using 3.0T high resolution magnetic resonance imaging (HRMRI).Materials and Methods Forty-nine patients with intracranial atherosclerosis underwent HRMRI.The characteristics of the plaques of middle cerebral artery were investigated,including morphology,distribution and enhancement.Patients were categorized as two groups (strong/mild and none) according to the strength of plaque enhancement,then clinical data were compared between the two groups and the risk factors were investigated.Acute infarction was classified as three subtypes (single/multiple perforating artery occlusion/arterial embolism) basedon diffusion weighted imaging,and the plaque characteristics of each subtype were investigated.Results Sixty-five plaques were identified in middle cerebral artery of 49 patients,62 plaques (95.4％) were eccentric,31 plaques (50.0％) were located at the ventral wall.Patients with low levels of high-density lipoprotein were significantly more prevalent in strong enhancement group (56.7％ vs.26.3％,P＜0.05).The percentage of strong enhancement plaque in arterial embolism group (88.9％) was significantly higher than non-arterial embolism group (36.4％) (P＜0.05).Conclusion Middle cerebral artery plaque distribution is correlated with ischemic stroke,strong enhancement plaque is associated with its vulnerability.HRMRI can provide information to predict the ischemic event and infarction pattern.

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Preparation and Properties of 68Ga-NOTA-SPIO as PET/MRI Dual-modal Imaging Agent

Fan WU ; Xinlu WANG ; Jilin YIN ; Jinhe ZHANG ; Xi OUYANG ; Zheng ZHOU ; Yuting YANG ; Jianqiu ZHONG

Chinese Journal of Medical Imaging.2017;25(5):329-334. doi:10.3969/j.issn.1005-5185.2017.05.003

Purpose To prepare 68Ga-NOTA-SPIO as PET/MRI dual mode imaging probe with high sensitivity and resolution,and further evaluate its in vitro and partly in vivo biological properties.Materials and Methods The precursor SPIO-PEG2000-NOTA was prepared and characterized.The precursor was radiolabeled by using one step method to prepare 68Ga-NOTA-SPIO as dual mode imaging probe.The labeling rate of the probe was determined by rapid thin-layer chromatography.Besides,the in vitro stability and lipid water partition coefficient of the probe were evaluated,and its biodistribution in normal mice was also observed.Results The precursor SPIO-PEG2000-NOTA with uniform dispersion and uniform particle size was prepared,and the dual mode probe 68Ga-NOTA-SPIO was synthesized.The labeling rate reached 99％,and the lipid water partition coefficient (Log P) was (-2.60±0.13).The radiochemical purity of the probe was higher than 95％,as it was incubated in the phosphate buffer and fetal bovine serum within 2 hours.The probe was mainly distributed in the liver and spleen of mice,and its clearance velocity in blood was fast.Conclusion The double mode probe 68Ga-NOTA-SPIO synthesized by one step method has high labeling rate with no need of purification,which has good physic-chemical properties and biocompatibility.The probe can be used in the further research of PET/MRI dual modality imaging.

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Evaluation of Left Ventricular Remodeling Index in Patients with Bone and Joint Degeneration Using Real-time Three-dimensional Echocardiography

Xinxin ZHAO ; Zhirong JIANG ; Xiaofan WANG ; Qifeng LU ; Xiaoxia SONG ; Yu TIAN

Chinese Journal of Medical Imaging.2017;25(5):383-387. doi:10.3969/j.issn.1005-5185.2017.05.014

Purpose Recently the incidence of bone and joint degeneration is increased,with the increasing of cardiovascular disease complication.This study aims to utilize realtime three-dimensional echocardiography (RT-3DE) in evaluating left ventricular remodeling index (LVRI),to guide treatment and improve the survival rate.Materials and Methods Fifty-seven cases of healthy volunteers (normal control group) and sixty-seven patients with bone and joint degeneration (research group) were respectively divided into two subgroups according to the age.Both groups underwent conventional echocardiography and RT-3DE.The LVRI,left ventricular end diastolic volume index (LVEDVI),left ventricular mass index (LVMI),left ventricular end systolic volume index (LVESVI) and left ventricular ejection fraction (LVEF) measured by different methods were analyzed,and the differences and correlations between groups and within each group were compared.Results The age of normal control group and research group was not significantly different (P＞0.05).The LVMI and LVRI in research group were significantly higher than those in the normal control group with same age (P＜0.05).The LVEDVI,LVMI and LVRI measured by two-dimensional echocardiography and M-mode echocardiography were higher than those measured by RT-3DE,and the difference was statistically significant (P＜0.05).Bland-Altman agreement analysis showed good agreement of measured LVRI using 2D echocardiography and RT-3DE.Conclusion Patients with bone and joint degeneration have left ventricular remodeling.RT-3DE can accurately assess LVRI with the advantages of convenience and lack of radiation,which can be widely used in clinic.

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Prediction of Myocardial Systolic Function Recovery with Myocardial Perfusion After Primary Percutaneous Coronary Intervention

Yajuan YANG ; Fei WANG ; Zhan MO ; Yangfan WU ; Huomei CHEN ; Xiaodan LIU ; Yuqiong LAI

Chinese Journal of Medical Imaging.2017;25(5):377-382. doi:10.3969/j.issn.1005-5185.2017.05.013

Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.

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Estimating Pulmonary Aortic Stenosis in Children by Continuous Wave Doppler and Electrocardiogram

Wei YAO ; Jian GAO ; Fei YU ; Jianbai LI ; Yang WANG ; Li XIAO ; Yang YANG ; Chuanju HOU

Chinese Journal of Medical Imaging.2017;25(5):374-376,382. doi:10.3969/j.issn.1005-5185.2017.05.012

Purpose Estimation of the degree of pulmonary artery stenosis (PS) in children patients before treatment can provide an important basis for the choice of treatment.This study explores the accuracy of non-invasive continuous wave Doppler (CW) and electrocardiogram (ECG) in estimating the degree of PS in children patients.Materials and Methods Sixty consecutive cases of PS children were collected from January 2012 to August 2016 in the General Hospital of Shenyang Military.The right ventricular pressure was estimated by measuring cross-pulmonary artery pressure gradient by CW,or estimated by measuring the amplitude of the V1R wave by ECG,which was then compared with that measured by cardiac catheterization respectively.Results The right ventricular pressure estimated by measuring cross-pulmonary artery pressure gradient by CW was positively correlated with that measured by cardiac catheterization (r=0.88,P＜0.05).The right ventricular pressure estimated by measuring the amplitude of the V1R wave by ECG was also positively correlated with that measured by cardiac catheterization (r=0.83,P＜0.05).Conclusion The right ventricular pressure estimated by CW or ECG has good consistency with that measured by cardiac catheterization.Both CW and ECG can be used as noninvasive methods for estimating the degree of PS in children.

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Echocardiographic Evaluation of Left Atrial Structure and Function in Patients with Paroxysmal Atrial Fibrillation After Radiofrequency Catheter Ablation

Sulei LI ; Guang ZHI ; Yang MU ; Bohan LIU

Chinese Journal of Medical Imaging.2017;25(5):370-373. doi:10.3969/j.issn.1005-5185.2017.05.011

Purpose To observe the changes of left atrial (LA) structure and function in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation by echocardiography in order to provide basis for clinical evaluation of surgery.Materials and Methods Forty-four patients with paroxysmal atrial fibrillation and treated with radiofrequency catheter ablation in PLA General Hospital from January 2015 to June 2016 were enrolled.According to whether or not to restore sinus rhythm after operation,the patients were divided into sinus rhythm group and atrial fibrillation recurrence group.The paramrters of LA including diameter,maximum and minimum volume,systolic volume,ejection fraction,active ejection fraction,conduit function index and dilatation index were measure by echocardiography before and at least 6 months after radiofrequency catheter ablation.The data were compared between and within groups.Results All patients were followed up for (6.0±0.5) months after ablation operation.29 of 44 patients (66％) maintained sinus rhythm;the anteroposterior,vertical,and left to right diameters of LA in patients with sinus rhythm after operation were significantly lower than those before operation,but the ejection fraction of LA increased (all P＜0.05).However,in patients with atrial fibrillation recurrence after operation,the volume of LA increased (P＜0.05);the diameters of LA did not show significant differences;the ejection and active ejection fraction of LA had significantly decreased (P＜0.05).Compared with patients with sinus rhythm after operation,patients with atrial fibrillation recurrence after operation were older and had higher proportion of hypertension (P＜0.05).Conclusion After ablation,the diameter of LA decreases and the ejection fraction increases in patients with sinus rhythm;the volume of LA increases and the function reduces in patients with atrial fibrillation recurrence.

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Ultrasonic Characteristics of Complex Fibroadenoma of Breast and Its Differential Diagnosis from Invasive Ductal Carcinoma

Meilian ZHANG ; Hu CHEN ; Ensheng XUE ; Liwu LIN ; Yimi HE

Chinese Journal of Medical Imaging.2017;25(5):365-369. doi:10.3969/j.issn.1005-5185.2017.05.010

Purpose To explore ultrasonic characteristics of complex fibroadenoma (CF) of breast and its differential diagnosis from invasive ductal carcinoma (IDC).Materials and Methods Sixty-one patients with CF and 81 patients with IDC from January 2010 to February 2016 in the Affiliated Union Hospital of Fujian Medical University were enrolled,and the CF and IDC were confirmed by pathology after operation.The preoperative sonographic findings of CF and IDC were retrospectively analyzed and compared.Results Fifty-nine cases with CF were detected by ultrasonography in 61 cases.Ultrasonic findings of 59 cases of CF showed as follows:79.7％ (47/59) of the CF cases with an aspect ratio ＜0.7;79.7％ (47/59) with blood flow signal of 0 to 1 level;72.9％ (43/59) with liquid dark area,including 67.8％ (40/59) with round or oval cystic fluid area showing local sievelike or diffused distribution;72.9％ (43/59) with irregular shape;61.0％ (36/59) with obscure boundary;61.0％ (36/59) with the largest diameter of tumor ＜2 cm;59.3％ (35/59) with calcifications,including 33.9％ (20/59) with coarse calcification,25.4％ (15/59) with microcalcification and 85.7％ (30/35) with distribution of calcified lesions along the linear high echo zone;54.2％ (32/59) with echo heterogenicity showing linear high echo and high echo in the middle and low echo.There were significant differences in the detection rates of internal regular fluid area,internal linear high echo or high echo area,and alcification distribution along the linear high echo between CF and IDC lesions (all P＜0.01).Compared with IDC,there were higher rates in CF for detecting lesions of largest diameter of tumor ＜2 cm,more regular shape,more clear border,poorer blood flow signal (P＜0.05),but there were lower rates in CF for detecting axillary lymph node enlargement,lesions with edge or spiculation and hyperechoic halo (P＜0.01).Conclusion Color Doppler ultrasonography is of great value in the diagnosis of CF and its differential diagnosis from IDC.

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Image Quality of Low Dose Computed Tomography Combined with Iterative Model Reconstruction Technique in Preoperative Evaluation of Breast Cancer

Yong GUO ; Yan JIANG ; Jing ZHANG ; Lijing SHI ; Qingjun WANG ; Kuihong ZHENG

Chinese Journal of Medical Imaging.2017;25(5):360-364. doi:10.3969/j.issn.1005-5185.2017.05.009

Purpose To investigate the value of low dose CT combined with iterative model reconstruction (IMR) technique for evaluation of both breast lesion and pulmonary metastasis in patients with breast cancer,and compare the effects of IMR,hybrid iterative reconstruction (HIR) and filtered back projection (FBP) techniques on image quality.Materials and Methods Twenty-one patients with solitary tumor confirmed by mammography and/or ultrasonography at Navy General Hospital from January to May in 2016 were enrolled,and the related breast imaging reporting and data system reached to level 4 and above.All patients underwent dynamic contrast-enhanced CT with different tube current for breast (scanning 6 times within 6 minutes) and chest scans;the conventional tube current (61 mAs) was used at the 2 minutes phase after injection,and the low tube current (10 mAs) was used at the other 5 phases.CT images were reconstructed with FBP,HIR and IMR techniques,respectively.The images of breast lesions and chest in 2 minutes scans were evaluated objectively and subjectively.Results The mean effective radiation dose was (2.15 ± 0.39) mSv.The images of 3 reconstruction techniques at the 2 minutes phase were compared,and the IMR images showed the lowest image noise and the optimal contrast to noise ratio (P＜0.05).The images quality of 3 kinds of reconstruction techniques was acceptable,of which IMR was better than HIR and FBP (P＜0.05).Conclusion Low dose CT scan combined with IMR technique can remain low radiation with dose of 2 mSv,while maintaining good image quality,which can be used for preoperative evaluation of both breast lesion and pulmonary metastasis in patients with breast cancer.

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