Lesion segmentation and identification of breast tumor on dynamic contrast-enhanced magnetic resonance imaging

Dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） can show subtle lesion morphol- ogy, improve the display of lesion definitions, and objectively reflect the blood supply of breast tumors; it can also reflect different strengthening patterns of normal tissues and lesion areas after medical tracer injection. DCE-MRI has become an important basis for the clinical diagnosis of breast cancer. To DCE-MRI data acquired from several hospitals across multiple provinces, a series of in-silico computational methods were applied for lesion segmentation and identification of breast tumor in this paper. The image segmentation methods include Otsu segmentation of subtraction images, signal-interference-ratio segmentation method and an improved variational level set method, each has its own application scope. After that, the distribution of benign and malignant in lesion region is iden- tified based on three-time-point theory. From the experiment, the analysis of DCE-MRI data of breast tumor can show the distribution of benign and malignant in lesion region, provide a great help for clinicians to diagnose breast cancer more expediently and lay a basis for medical diagnosis and treatment planning.     

DIAGNOSIS AND TREATMENT OF PHEOCHROMOCYTOMAS IN URINARY BLADDER

Objective To investigate the diagnosis and treatment of pheochromocytomas in urinary bladder and review relative literatures. Methods The clinical data of 6 cases of bladder pheochromocytoma were retrospectively analyzed. Bladder submucosal mass was detected by B-ultrasound in 6 cases,computerized tomography (CT) in 4,and cystoscopy in 3.All patients were treated with surgical operation.Results Two patients showed obvious fluctuation of blood pressure during operation.All patients were pathologically diagnosed as pheochromocytoma postoperatively.Five patients were followed up (from 3 months to 7 years),and their blood pressure returned to normal No patient had relapse and malignancy.Conclusion Typical hypertension during urination and hematuria constitute the chief symptoms of bladder pheochromocytoma.B-ultrasound,CT,and cystoscopy are the main methods for the localization of the lesions.Partial cystectomy or excision of the tumor is the preferred management and postoperative long-term follow-up is necessary.     

DIFFERENTIAL DIAGNOSIS IN THE INTRACRANIAL DISEASES： PROTON MAGNETIC RESONANCE SPECTROSCOPY STUDY

Protonmagneticresonancespectroscopy (1H MRS)isanewtechniqueoffunctionalimaginginbrainandprovidesauniquenoninvasivetoolforex aminingmetabolisminvivonow .Inrecentyear ,therearesomereportsaboutprotonMRSingrowthofbrainandhypoxia ischemicencephalopathy(HIE) [1- 4] ,butfewarticlesaboutclinicalapplica tionofprotonMRSindiagnosistumoursandtheirdifferentiationfromnon neoplasticlesions .WestudiedMRSin 38braintumorsand 14brainnon neoplasticlesions.Herewereporttheresults .MATERIALSANDMethods1　…     

女性外阴病变及其与HPV16/18、HPV6的相关性

目的研究外阴病变及其与HPV16/18、HPV6的关系。方法收集西安交通大学医学院第二附属医院手术治疗的44例女性外阴病变患者的临床病理资料,包括鳞癌11例,鳞状上皮内瘤变(VIN)10例,尖锐湿疣9例及白色病变14例。采用免疫组化SP方法检测HPV16/18E6蛋白、HPV6L1蛋白的表达。结果①4组外阴病变患者年龄中位数依次为:外阴鳞癌61岁、VIN 45.5岁、尖锐湿疣24岁、外阴白色病44岁,尖锐湿疣组中位年龄低于外阴鳞癌组及白色病变组(P<0.05),其余各组间中位年龄无统计学差异。②HPV16/18E6蛋白在外阴白色病变组、尖锐湿疣组、VIN组及外阴鳞癌组的阳性率分别为2/14、3/9、3/10、8/11,外阴鳞癌组高于白色病变组(P<0.05),其余各组间无统计学差异;HPV6L1蛋白在外阴白色病变组、尖锐湿疣组、VIN组、外阴鳞癌组的阳性率分别为1/14、8/9、4/10、3/11,尖锐湿疣组高于其他各外阴病变组(P<0.05),其余各组间比较差异无统计学意义。③HPV16/18E6蛋白、HPV6L1蛋白在早期外阴鳞癌的阳性率均高于中晚期(P<0.05);HPV16/18E6蛋白、HPV6L1蛋白表达均与外阴鳞癌的组织学分级、年龄分组、绝经情况、产次不相关(P>0.05);HPV16/18E6蛋白与HPV6L1蛋白在外阴鳞癌中的表达不相关(P>0.05)。结论外阴病变的发病与年龄及HPV16/18、HPV6感染有关;外阴鳞癌中HPV16/18、HPV6的感染率与FIGO分期有关,HPV16/18感染率与HPV6的感染率无关。     

77例乳癌针吸细胞学检查与病理组织学检查的对照分析

<正> 应用针吸细胞学检查在临床上诊断乳房包块已获得了普遍的重视和肯定。目前已逐渐广泛应用于乳腺癌诊断。我们在临床实际工作中,应甩此方法已近十年,为了提高细胞学诊断水平,现就77例乳癌针吸细胞学检查和切除标本组织学检查进行对照分析如下。资料与方法 1973年1月—1982年12月我科对乳腺肿块应用针吸细胞学检查共125例,其中20例临床和细胞学不怀疑恶性病变;5例乳腺增生病,细胞学检查显示轻度上皮增生;23例细胞学诊     

乳腺肉瘤21例临床分析

我院自1956年到1990年共收治乳腺恶性肿瘤病人2644例,其中经病理确诊的乳腺肉瘤21例,占同期乳腺恶性肿瘤病人的0.8%。6例腋下淋巴结肿大,占28.6%。病检均非肿瘤转移。本组资料表明乳腺肉瘤的发病年龄较乳癌为轻,45岁以上及病史1年以上者预后较好。因乳腺肉瘤多经血道转移或局部浸润,很少转移到腋下,治疗以肿瘤切除和乳腺单切为主,放疗的价值还需进一步探讨。     

MDR1、BCRP和LRP基因在乳腺癌组织中的表达及其意义

目的探讨多药耐药基因(MDR1)、乳腺癌耐药蛋白(BCRP)及肺耐药蛋白(LRP)mRNA在乳腺癌组织中的表达及其相互关系,分析它们与乳腺癌临床病理特征的关系。方法采用RT-PCR方法检测2007年1月至2007年12月在宁夏医科大学附属医院手术切除的42例乳腺癌组织、42例癌旁组织及50例乳腺良性病变中MDR1、BCRP和LRP mRNA的表达。结果乳腺癌组织中MDR1、BCRP、LRP mRNA的阳性表达率分别为40.47%、38.09%及61.90%,与癌旁组织及乳腺良性病变组织相比阳性表达率均有统计学差异(P<0.05)。MDR1mRNA表达与绝经状况呈完全正相关(r=0.398,P<0.01),与腋窝淋巴结状况呈完全正相关(r=0.398,P<0.01);BCRP mRNA表达与腋窝淋巴结状况呈正相关(r=0.355,P<0.05);LRP mRNA表达与绝经状况、年龄、腋窝淋巴结状况及肿瘤大小之间均无相关性(P>0.05);MDR1mRNA和BCRP mRNA表达呈正相关(r=0.652,P<0.01),LRP mRNA与MDR1mRNA表达无相关性(r=0.147,P>0.05);LRP mRNA和BCRP mRNA表达无相关性(r=0.111,P>0.05)。2个耐药基因共表达率为47.61%,2种或3种耐药基因共表达率为61.89%。结论乳腺癌组织中存在耐药基因MDR1、BCRP和LRP的表达,单基因和多基因协同作用,以多基因共表达为主;检测MDR1和BCRP基因表达水平可辅助临床判断乳腺癌患者的预后。     

BLOOD FLOW PATTERN AND QUANTITATIVE STUDY IN SOLITARY PULMONARY NODULES WITH DYNAMIC CONTRAST-ENHANCED MRI

Objective To evaluate the efficacy of contrast enhanced dynamic MRI in differentiating solitary pulmonary nodules(SPNs). Methods Eighty-three patients with SPNs undertaken contrast enhanced dynamic MRI. Time-signal intensity curve (T-SI Curve) was made. Peak height (PH), steepest slope (SS), maximum enhancement (Emax) and the enhancement rates of signal intensity were recorded at the first ( E1 ), second ( E2 ),third (E3) , fourth ( E4), fifth (E5) , and sixth (E6) minute after injection. Results Malignant nodules and inflammatory nodules enhanced significantly higher than benign nodules, and malignant nodules and inflammatory nodules showed obviously higher PH, SS, Emax, E1-E6 values than benign nodules( P ＜ 0. 01 ). There were no significant differences in PH, SS, E E1-E6 values between malignant nodules and inflammatory nodules( P ＞ 0. 05 ).Conclusion Contrast enhanced dynamic MR imaging can provide SPNs' hemodynamic information and is helpful in differentiating SPNs.     

复杂病例的经皮冠状动脉腔内成形术

1988年元月至1997年10月我院完成的复杂经皮冠状动脉腔内成形术（Percutaneoustransluminalcoronaryangioplasty,PTCA）74例，占同期PTCA总例数的49．3％，其中年龄大于或等于70岁者10例，不稳定心绞病34例，左心室射血分数小于40％者6例；48例为多支血管病变。PTCA共扩张85在血管，靶病变93处，A型病变15处，B型病变53处，C型病变25处。7例采用灌注球导管，28例植入冠状动脉内支采，1例行冠状动脉内膜定向切除术。PTCA病倒成功率93．2％，病变成功率90．3％，本前平均狭窄（89．5±82）％，术后平均狭窄（16．9±6．2）％．死亡2例，无息性心肌梗塞和急诊冠状动脉搭桥者。讨论了复杂病例PTCA的成功率、可能出现的风险及处理对策，表明复杂病例PTCA仍可取得较好临床效果。     

AN IMMUNOHISTOCHEMICAL STUDY ON EXPRESSION OF CD44v6 PROTEIN IN HUMAN GALLBLADDER CARCINOMA

ＣＤ4 4ｖ6 ｐｒｏｔｅｉｎｉｓａｃｅｌｌａｄｈｅｓｉｏｎｍｏｌｅｃｕｌｅｅｘ ｐｒｅｓｓｉｎｇｏｎｔｈｅｃｅｌｌｓｕｒｆａｃｅ .Ｒｅｃｅｎｔｌｙ ,ｍａｎｙｓｃｈｏｌａｒｓｎｏｔｉｃｅｄｔｈｅｒｅｌａｔｉｏｎｂｅｔｗｅｅｎＣＤ4 4ｖ6ｅｘｐｒｅｓｓｉｏｎａｎｄｎｅｏｐｌａｓｍｄｅｖｅｌｏｐｍｅｎｔａｓｗｅｌｌａｓｐｒｏｇｒｅｓｓ ,ｂｕｔｔｈｅｒｅ ｐｏｒｔｓａｂｏｕｔｔｈａｔａｒｅｓｃａｒｃｅｉｎＧＢＣ .ＩｎｏｒｄｅｒｔｏｓｔｕｄｙｔｈｅｃｌｉｎｉｃｓｉｇｎｉｆｉｃａｎｃｅｓｏｆＣＤ4 4ｖ6ｅｘｐｒｅｓ…     

经皮穿刺冠状动脉腔内成形术68例分析

我院近年共完成经文穿刺冠状动脉腔内成形术（PTCA）68例，其中单支病变37例（54．4％），双支病变22例（32．4％），三支病变9例（13．2％）。PTCA共扩张79处病变，A型病变39处（49．4％），B型病变30处（37．9％），C型病变10处（12．7％）。3例采用邓导丝技术，5例采用灌注球囊导管，8例放置冠状动脉内支架，三例进行了冠状动脉内膜斑块定向切除术。PTCA的病倒成功率97.1％，病变成功率93．5％，本前平均狭窄（878±8．4）％，术后平均狭窄（14．1±46）％。1例死亡，无息性心肌梗塞和急诊冠状动脉搭桥者。讨论了PTCA的适应症、影响成功的因素以及并发症的预防，表明PTCA是冠心病的有效治疗手段。     

高频超声及钼靶X线检查在乳腺癌诊断中的应用价值

目的评价单一高频超声、钼靶X线及联合应用钼靶、超声对乳腺癌的诊断价值。方法选择2009年4月至2012年4月在我院确诊的318例女性乳腺癌患者,其中104例仅行高频超声检查,98例仅行钼靶X线检查,两者联合应用者116例。结果钼靶X线诊断符合率为78.6%,误诊率11.2%,漏诊率10.2%;单独高频超声诊断符合率为80.7%,误诊率10.6%,漏诊率8.7%;联合应用超声、钼靶X线诊断符合率为93.1%,误诊率4.3%,漏诊率2.6%。单独应用高频超声或钼靶X线检查与联合诊断的检出率及漏诊率有统计学差异,误诊率无统计学差异。结论钼靶X线与超声检查各有优势,二者联合应用具有良好的诊断互补性,能明显提高乳腺癌的检出率和准确率,降低误诊率和漏诊率。     

二维超声、弹性成像对乳腺肿块诊断价值的评价

目的 评价二维超声、弹性成像在鉴别诊断乳腺良、恶性肿块中的价值.方法 对随机来我院检查的103例患者共109个乳腺肿块分别进行二维超声和弹性超声检查,结果与病理对照并进行分析.结果 二维超声和弹性成像在鉴别乳腺良、恶性肿块中的价值相当(敏感性、特异性和准确性分别为81.58％、80.28％、80.73％和84.21％,...     

测定游离甲状腺素指数观察甲功状态与乳腺癌的关系

我们测定了327例30岁以上健康妇女的FT_4I值,测定了124例(30岁以上女性)乳腺良性肿瘤患者和乳腺癌患者的FT_4I值。从我们测定的结果来看,FT_4I值的变化同年令有关,年令愈高,FT_4I愈低。将乳腺良性肿瘤患者的FT_4I值同乳腺癌患者的FT_4I值相比较,我们认为乳腺癌患者FT_4I值(40岁以上年令组)显示偏低倾向。     

CT导向胸内疑难病灶的经皮活检20例

报告CT导向胸内邻近大血管或直经小于3cm的病灶的经皮针吸活检术20例。这些疑难病灶的径皮活检术操作困难，危险性大，并发症多。本组正确诊断丰85％，其中恶性肿瘤为80％，良性病变为90％。术后小量气胸2例（1％），小量出血1例（5％）。CT扫描能精确确认病灶和穿刺针的位置，并能清楚显示心脏和大血管的轮廓，因此疑难病灶的经皮活检应该在CT导向下操作。     

CT导向胸内疑难病灶的经皮活检20例

报告CT导向胸内邻近大血管或直经小于3cm的病灶的经皮针吸活检术20例。这些疑难病灶的径皮活检术操作困难，危险性大，并发症多。本组正确诊断丰85％，其中恶性肿瘤为80％，良性病变为90％。术后小量气胸2例（1％），小量出血1例（5％）。CT扫描能精确确认病灶和穿刺针的位置，并能清楚显示心脏和大血管的轮廓，因此疑难病灶的经皮活检应该在CT导向下操作。     

基质金属蛋白酶-9和CD_(44v6)表达对乳腺癌转移和预后的意义

目的　探讨基质金属蛋白酶 9(MMP 9)及CD44v6在乳腺癌组织中的表达及其与肿瘤转移、预后的关系。方法　应用免疫组化方法检测 80例乳腺癌及 10例乳腺增生病中MMP 9及CD44v6的表达 ,并用计算机图像分析系统测定表达的吸光度值 (A)。结果　乳腺癌MMP 9和CD44v6表达的吸光度值显著高于增生病。淋巴结转移与MMP 9表达有关、与CD44v6表达有相关趋势。MMP 9与PR有负相关性、与ER有负相关趋势。MMP 9与CD44v6间无相关关系。MMP 9表达的吸光度值在生存 3年以上组低于 3年以下组 ,与乳腺癌患者生存情况有负相关关系。结论　有MMP 9表达的乳腺癌 ,肿瘤的侵袭和转移发生较早、预后差 ,MMP 9表达的测定可作为乳腺癌浸润、转移的重要分子学标志     

Diagnostic value of diffuse and peripheral lung lesions by transbronchial lung biopsy

Objective To evaluate the diagnostic value of transbronchial lung biopsy (TBLB) via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions. Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions. Results Eighty-nine final diagnosis cases via TBLB only once, the diagnostic rate of double lung diffuse lesions was the highest, [51.06% (24/47)], local non-nodule lesions, nodule lesions, cavity lesions were 33.33%(23/69), 29.91%(35/117), and 28.57%(4/14), respectively. Among 24 diagnostic cases of double lung diffuse lesions, there were 6 cases of pneumonia of pulmonary tuberculosis, 9 cases of lung carcinoma, 7 cases of adenecarcinoma; 6 cases of pneumonia, 2 cases of fungous infection, and 1 case of lung hemosiderusis. The diagnostic yield about 58 cases of local lesions was low, among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%. In 89 cases of peripheral lung lesions with histological diagnosis, lung carcinoma and pulmonary tuberculosis were frequent diseases, which accounted for 86.52%. Conclusion TBLB is a reliable, safe, effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.     

贲门区癌可手术切除的相关X线征象

为探讨贲门癌的 X线征象在病变范围的确定及评估手术可能性中的价值 ,收集 10 6例采用双对比检查并经手术及病理证实的贲门癌 ,对其 X线表现与手术、病理所见进行对照分析。结果 :10 6例中 ,90例行开腹探查术 (其中病变切除 70例 ,未能手术切除 2 0例 ) ,16例因失去探查机会而采用非手术疗法。提示 :贲门癌的有些 X线征象在决定能否手术切除具有重要的意义。     

血清和支气管肺泡灌洗液中癌胚抗原及透明质酸测定对肺癌的诊断意义

应用放免法测定了７４例肺癌和７６例良性肺病患者血清（Ｓ）和支气管肺泡灌洗液（ＢＡＬＦ）中癌胚抗原（ＣＥＡ）及透明质酸（ＨＡ），同时测定了５８例健康人Ｓ－ＨＡ。结果显示：肺癌患者Ｓ－ＣＥＡ极显著高于良性肺病患者（Ｐ＜０．００１），肺癌患者Ｓ－ＨＡ极显著高于健康人和良性肺病患者（Ｐ均＜０．００１）。肺癌患侧ＢＡＬＦ－ＣＥＡ和ＢＡＬＦ－ＨＡ极显著高于肺癌健侧、良性肺病患侧和健侧（Ｐ＜０．００１或Ｐ＜０．００２）。根据各项指标在肺癌时的阳性率，选用Ｓ－ＣＥＡ、ＢＡＬＦ－ＣＥＡ和ＢＡＬＦ－ＨＡ作为诊断指标，当３项阳性时对肺癌诊断的敏感性为５３％，特异性为９７％、阳性预示值为９５％，用性预示值为７６％，准确性为７２％。