超声光散射成像乳腺诊断系统对T1期乳腺癌的诊断价值

目的探讨超声光散射乳腺诊断系统(简称乳光超)对T₁期乳腺癌的诊断价值。 方法本研究共纳入2016年4月至2018年4月到成都市妇女儿童中心医院治疗的超声检查3级及以上(排除6级)患者共2 245例。患者同时完成了超声及乳光超检查,其中,经活组织检查且有完整病理资料的患者共1 157例,对其资料进行回顾性分析。按肿瘤最大直径将1 157例分为3组：S1组(≤1.0 cm)共452例,S2组(1.1～2.0 cm)共489例,S3组(>2.0 cm)共216例。采用受试者工作特征(ROC)曲线分析2种检查方法的诊断效能,计算ROC曲线下面积及95%CI, ROC曲线下面积的比较采用Medcalc V19.0.4软件行Z检验。2种方法敏感度及特异度的比较采用χ²检验或Fisher确切概率法;2种方法分别与病理检查结果比较,采用配对χ²检验(McNemar检验)。 结果1 157例中,恶性144例(12.4%),全部为浸润性导管癌,良性1 013例(87.6%),其中纤维腺瘤852例,导管内乳头状瘤49例,腺病112例。超声诊断乳腺癌的敏感度和特异度分别为90.2%(130/144)和67.7%(686/1 013),诊断准确率为70.5(816/1 157),乳光超诊断乳腺癌的敏感度和特异度分别为94.4% (136/144)和81.8%(829/1 013),诊断准确率为83.4% (965/1 157)。2种方法比较,乳光超诊断的敏感度与超声相比,差异无统计学意义(χ²＝1.772,P＝0.183),但乳光超的诊断准确率及特异度比超声高(χ²＝55.148,P<0.001,χ²＝53.515,P<0.001)。ROC曲线结果显示：对0～1.0 cm及1.1～2.0 cm肿块,乳光超诊断效能优于超声(Z＝2.384,P＝0.034;Z＝3.962, P<0.001);而对于>2.0 cm的肿块,乳光超的诊断效能与超声比较,差异无统计学意义(Z＝1.911, P＝0.056)。亚组分析显示：对于0～1.0 cm小肿块,乳光超特异度为85.7%(359/419),高于超声特异度72.3%(303/419)(χ²＝22.555,P<0.001)。对于1.1～2.0 cm小肿块,乳光超特异度为80.4%(349/434),高于超声特异度66.1%(287/434)(χ²＝22.613,P<0.001)。对于>2.0 cm肿块,乳光超特异度为73.1%(117/160),超声特异度为58.1%(93/160),乳光超特异度优于超声(χ²＝7.979,P＝0.005)。各亚组中,乳光超与超声的敏感度比较,差异均无统计学意义(P＝0.427; χ²＝0.374,P＝0.541; P＝1.000)。 结论乳光超对T₁期乳腺癌的诊断优于超声,可作为早期乳腺癌诊断的有效手段之一。     

超声光散射成像联合红外线对乳腺肿瘤诊断的应用价值

目的：探讨超声光散射成像系统联合红外线检查对鉴别乳腺良、恶性肿瘤的临床应用价值。方法：随机选取113例乳腺肿物患者进行超声光散射和红外线检查,与术后病理结果对照,评价其诊断符合率。结果：超声光散射联合红外线检查结果良性58例,恶性47例,术后病理诊断良性病变61例,恶性病变52例。联合应用诊断特异性95.08%,准确性92.92%,阳性预测值94%,假阳性率4.92%。结论：超声光散射成像系统可作为早期乳腺癌检测的新手段,联合红外线检查可提高诊断符合率,对乳腺癌的早期诊断,减少漏诊、误诊具有重要价值。     

超声光散射成像联合红外线对乳腺肿瘤诊断的应用价值

目的:探讨超声光散射成像系统联合红外线检查对鉴别乳腺良、恶性肿瘤的临床应用价值。方法:随机选取113例乳腺肿物患者进行超声光散射和红外线检查,与术后病理结果对照,评价其诊断符合率。结果:超声光散射联合红外线检查结果良性58例,恶性47例,术后病理诊断良性病变61例,恶性病变52例。联合应用诊断特异性95.08%,准确性92.92%,阳性预测值94%,假阳性率4.92%。结论:超声光散射成像系统可作为早期乳腺癌检测的新手段,联合红外线检查可提高诊断符合率,对乳腺癌的早期诊断,减少漏诊、误诊具有重要价值。     

超声光散射乳腺成像诊断乳腺癌假阳性率分析

目的：超声光散射乳腺成像系统（OPTIMUS）是多模式的可以进行早期乳腺癌普查、诊断及疗效检测的系统。本研究回顾经手术后病理证实的160 例乳腺肿瘤的OPTIMUS系统表现与病理结果对比分析,评价OPTIMUS系统的临床应用价值。方法：对160 例乳腺肿瘤患者进行OPTIMUS系统检查,将检查结果及手术病理进行总结,并与相应的钼靶及超声结果进行对比,用卡方检验分析结果有无统计学差异。结果：OPTIMUS系统诊断良性病变42例,恶性病变118 例。术后病理诊断良性病变60例,恶性病变100 例。假阳性率为30.0% ,假阴性率为0。OPTIMUS系统诊断乳腺癌准确性88.8%（142/160）,敏感性100.0%（100/100）;相应超声及钼靶检测准确性分别为87.6% 和87.1% ,无统计学差异;敏感性分别为86.8% 和87.1% ,与OPTIMUS系统有统计学差异。结论：OPTIMUS系统对诊断乳腺恶性肿瘤的准确性及敏感性较高,是提高乳腺良恶性病变鉴别诊断的有效方法。     

超声光散射成像技术在乳腺癌诊断中的应用价值

目的:应用超声光散射成像技术及彩色多普勒超声,探讨其在乳腺癌诊断中的临床应用价值。方法:选取我院乳腺外科行外科手术治疗的女性患者103例,共156个乳腺包块,术前超声常规检查乳腺包块。彩色多普勒超声探查血流分级情况,同时超声光散射系统测量总血红蛋白浓度。每种方法分别计算准确度、敏感度、特异度、阳性预测值和阴性预测值,对乳腺肿物诊断的准确度进行组间分析。结果:超声光散射成像技术诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为76.9%、89.6%、67.4%、67.4%、89.6%。彩色多普勒超声诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为77.6%、74.6%、79.8%、73.5%、80.7%。超声光散射成像技术联合彩色多普勒超声诊断乳腺癌的准确度、敏感度、特异度、阳性预测值和阴性预测值分别为89.7%、95.5%、85.4%、83.1%、96.2%。DOT联合彩色多普勒超声与单独DOT或单独彩色多普勒超声诊断乳腺疾病的准确度差异有统计学意义。结论:超声光散射成像技术联合应用彩色多普勒超声可提高乳腺癌诊断的准确度,为临床医生早期治疗奠定基础。     

超声光散射成像系统筛查早期乳腺癌

[目的]探讨超声光散射成像系统(OPTIMUS)筛查早期乳腺癌的价值.[方法]于2010年8月到2011年8月间行超声和OPTIMUS乳腺检查共3 730人,对其中肿块≤2cm的205例患者的211个肿块的超声、O PTIMUS和病理结果进行分析.[结果]211个肿块,38个经病理确诊为乳腺癌.OPTIMUS为自动分级...     

超声光散射乳腺成像诊断乳腺癌的临床价值

目的 探讨运用超声光散射乳腺成像（OPTIMUS）系统对乳腺肿块的诊断价值。方法回顾经病理检查证实的136例乳腺肿瘤的OPTIMUS系统表现,与病理检查结果对比分析,同时用一致性检验评价其与病理、超声、钼靶X线检查的一致性,并绘制受试者工作特征（receiver operating characteristic,ROC）曲线,计算曲线下面积（area under the curve,Auc）,判断三种检查手段的准确性,评价OPTIMUS系统的临床应用价值。结果136例患者术后病理诊断良性病变50例,恶性病变86例。OPTIMUS系统诊断良性病变34例,恶性病变102例,其中16例被过度诊断为恶性。其与超声及钼靶X线检查的一致性检验Kappa值分别为0．536、0．386。0PTIMUS系统、超声、钼靶X线与病理检查的一致性检验Kappa值分别为0．729、0．616、0．649。OPTIMUS系统、超声及钼靶X线检查的AUC分别为0．840（95％C10．764～0．916）、0．817（95％CI0．742～0．893）及0．837（95％CI0．771～0．902）。结论OPTIMUS系统对诊断乳腺恶性肿瘤的准确性及敏感性较高,可以提高乳腺癌患者的检出率,减低漏诊率。     

超声成像联合光散射成像系统对乳腺肿瘤良恶性鉴别的应用价值

目的: 探讨超声成像联合光散射成像系统(简称\     

超声光散射断层成像中血红蛋白值与乳腺癌CerbB-2表达相关性的研究

目的:探讨超声光散射断层成像技术中血红蛋白值(HBT)与乳腺癌中原癌基因CerbB-2表达的相关性。方法:87例乳腺癌患者经超声光散射断层成像系统测量HBT值,免疫组化SP法检测CerbB-2在乳腺癌组织中的表达情况,分析HBT值与CerbB-2表达的关系。结果:乳腺癌组织中CerbB-2阴性、阳性的HBT值之间的差异有统计学意义(P<0.05),CerbB-2的表达与HBT值呈正相关(r=0.675,P<0.001)。结论:超声光散射成像作为一种新的功能性乳腺成像技术,其检测的HBT值可为临床上判断肿瘤CerbB-2表达及患者诊疗计划的制定提供有价值的参考。     

磁共振成像在乳腺肿瘤诊断中应用

乳腺肿瘤是妇女中十分常见的肿瘤,对于乳腺肿瘤的检测手段在近二十年来有了迅速的进展。破共振成像(magnetic resonance image,MRI)具有多个成像参数,能提供丰富的诊断信息。其优点为:无电离辐射,安全可靠,以及并具有极好的软组织分辨能力。在国外已逐步应用于乳癌的诊断,MRI能分辨出3mm大小的原发灶及微转移灶,从而成为乳腺X线摄片、B超、热图像、CT等检查手段的有益补充。一、乳腺肿癌的MR特性磁共振成像术是建立在磁共振现象的基础上,其中纵向弛豫时间(T_1)和横向弛豫时问(T_2)是MRI的两个重要参数。早在1971年,Damadiam     

Comparison between Computer Tomography and Magnetic Resonance Imaging in the Diagnosis of Small Hepatocellular Carcinoma

Background: Hepatocellular carcinomas (HCCs) less than 2 cm in diameter generally demonstrate a good outcome after curative therapy. However, the diagnosis of small HCC can be problematic and requires one or more dynamic imaging modalities. This study aimed to compare the sensitivity and agreement between CT and MRI for the diagnosis of small HCCs. Methods: CT and/or MRI scans of HCCs (1-2 cm) diagnosed by histopathology or typical vascular pattern according to the 2005 AASLD criteria were blindly reviewed by an abdominal radiologist. The reports were defined as conclusive/typical when arterial enhancement and washout during the portal/delayed phases were observed and as inconclusive when typical vascular patterns were not observed. The sensitivity and Cohen’s kappa (k) for agreement were calculated. Results: In 27 patients, 27 HCC nodules (1-2 cm) were included. Diagnosis with a single-imaging modality (CT or MRI) was 81 % versus 48 % (p = 0.01). The CT sensitivity was significantly higher than MRI (78 % versus 52 %, p = 0.04). Among 27 nodules that underwent both CT and MRI, a discordance in typical enhancement patterns was found (k = 0.319, p = 0.05). In cases with inconclusive CT results, MRI gave only an additional 3.7 % sensitivity to reach a diagnosis. In contrast, further CT imaging following inconclusive MRI results gave an additional 29.6 % sensitivity.Conclusions: A single typical imaging modality is sufficient to diagnose small HCCs. Compared with MRI, multiphasic CT has a higher sensitivity. The limitations of MRI could be explained by the greater need for patient cooperation and the types of MRI contrast agent.     

前纵隔肿瘤的CT和MR诊断比较

[目的]比较CT和MR对于前纵隔肿瘤的诊断准确性。[方法]对比分析127例病理诊断为前纵隔肿瘤患者术前均接受的CT和MR检查影像学表现。[结果]CT诊断符合率61.41%（78/127）,MR符合率55.90%（71/127）,CT联合MR符合率67.32%（85.5/127）。[结论]对于纵隔肿瘤（胸腺囊肿除外）,CT的诊断准确率等同于或更优于MR,CT应作为前纵隔肿瘤首选诊断检查,但对于伴出血或炎症的胸腺囊肿选择MR更加合适。     

Use of Breast Magnetic Resonance Imaging and Ultrasonography for Identifying Nonpalpable Axillae Metastases in Newly Diagnosed Breast Cancer Patients

Background

The metastasis of axillary lymph node (ALNs) is a critical step in the initial cancer staging of newly diagnosed breast cancer (BC) patients. Various imaging modalities can enhance the sensitivity of clinical examination in assessing the ALN status.

早期乳腺癌动态增强MRI诊断

 目的　提高对早期乳腺癌动态增强MRI征象的认识。方法　分析 9例早期乳腺癌动态增强MRI表现特征 ,总结早期乳腺癌的特征性MRI表现。结果　早期乳腺癌动态增强MRI表现 :①病灶形态多数表现为片状、团块状强化区域 ,边界不清 ,形态不规则 ,少数表现为分叶状小结节或沿导管走行的条带状强化 ;②MIP :多数病灶周边可见细小密集血管影 ;③SI Time曲线大部分为II型和III型 ,但少数为I型。结论　早期乳腺癌MRI表现具有一定特征性 ,但有些与乳腺良性病变易混淆 ,对可疑病变的诊断必须结合X线钼靶摄影才能提高诊断准确性。     

Single Magnetic Resonance Imaging vs Magnetic Resonance Imaging/Computed Tomography Planning in Cervical Cancer Brachytherapy

AimsTo compare differences in dose to the target volume and organs at risk (OARs) for ring and tandem brachytherapy using individualised magnetic resonance imaging (MRI)/computed tomography-based three-dimensional treatment plans for each application vs plans based on a single scan for all fractions.Materials and methodsThe study was carried out in 10 patients with carcinoma of the uterine cervix, treated with external beam radiotherapy and five fractions of high dose rate brachytherapy. Planning was carried out using MRI for the first fraction and computed tomography for each of the four subsequent fractions. The MRI-based plan was taken as the reference and the single-plan procedure was calculated by using the weights from the reference plan to calculate the dose distribution for each subsequent computed tomography-based plan. The high-risk clinical target volume (HRCTV) and OARs were delineated as per GEC-ESTRO guidelines. Total doses from external beam radiotherapy and brachytherapy were summated and normalised to a 2 Gy fraction size.ResultsThe mean D₉₀ for the HRCTV was 81.9 Gy when using one plan and 84 Gy when using individual treatment plans. Similarly, the mean D_2cc was 75.68 Gy vs 74.99 Gy for the bladder, 55.84 Gy vs 56.56 Gy for the rectum and 64.8 Gy vs 65.5 Gy for the sigmoid. Ring rotation was identified in three patients, resulting in a change in dwell positions, which otherwise could have led to either a high bladder dose or suboptimal coverage of the HRCTV.ConclusionsOur study has shown that a single-plan procedure achieved acceptable dosimetry in most patients. However, the individualised plan improved dosimetry by accounting for variations in applicator geometry and the position of critical organs.