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Preferences of referring physicians regarding the role of radiologists as direct communicators of test results. 转诊医生对放射科医生作为检测结果直接沟通者的角色的偏好。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2017-01-01 DOI: 10.5152/dir.2016.16325
N. Erdoğan, H. İmamoğlu, S. Görkem, S. Doğan, S. Şenol, A. Öztürk
PURPOSE Currently, there is a growing need for patient-centered radiology in which radiologists communicate with patients directly. The aim of this study is to investigate the preferences of referring physicians (RPs) regarding direct communication between radiologists and patients. METHODS This study was conducted in a single academic hospital using a survey form. The survey items investigated the preferences of RPs regarding: 1. who should be the communicator of test results when a patient with abnormal findings requests information (the options were the radiologist; another health professional with communication skills training (CST); and the RP with CST); and 2. how the communication activity should be conducted if the radiologist is obliged (or chooses) to communicate with the patient directly (the options were that the disclosure should be limited to the findings in the radiology report; the radiologist should emphasize that the RP is the primary physician; and the communication activity should be conducted in accordance with guidelines established by consensus). The respondents were 101 RPs from various fields of specialty; they were asked to rate the items using a 5-point Likert scale. The effects of age, sex, field of specialty (surgical vs. nonsurgical), and total years of experience as a medical specialist on the ratings were statistically compared. RESULTS Most RPs preferred that the radiologist transmit the information to the RP without communicating directly with the patient (89.1%). Although 69.3% of the RPs declared that health professionals with CST have priority in communication, 86.1% declared that the RP should be the person who received CST. If the radiologist communicates with patients directly, the RPs favored that 1. the disclosure should be limited to the findings in the radiology report (95%); 2. the communication activity should include an emphasis on the RP as the patient's primary agent (84.1%); and 3. communication should be conducted in accordance with guidelines established by consensus (73.2%). The percentage of strong opinions did not change significantly with regard to age, sex, field of specialty, or total years of experience, except that surgeons expressed strong disagreement with delegating the communication activity to another health professional who received CST (χ² = 9.9; P = 0.042). CONCLUSION These findings may serve as a basis to implement institutional and national policies for patient-centered radiology.
目前,对以患者为中心的放射学的需求日益增长,在这种放射学中,放射科医生与患者直接沟通。本研究的目的是调查转诊医师(rp)对放射科医师与患者直接沟通的偏好。方法本研究采用问卷调查方式在某一学术医院进行。调查项目调查了rp的偏好:1。当有异常发现的患者要求提供信息时,谁应该是测试结果的沟通者(选项是放射科医生;另一名接受沟通技巧培训的保健专业人员;和带CST的RP);和2。如果放射科医生有义务(或选择)直接与患者沟通,应如何进行沟通活动(选项是披露应限于放射学报告中的发现;放射科医师应强调RP是主治医师;沟通活动应按照协商一致确定的指导方针进行)。调查对象为来自不同专业领域的101名rp;他们被要求用5分李克特量表对这些项目进行评分。年龄、性别、专业领域(手术与非手术)和作为医学专家的总经验年数对评分的影响进行统计比较。结果绝大多数RP(89.1%)倾向于放射科医师将信息传递给RP,而不直接与患者沟通。尽管69.3%的RP声称拥有CST的卫生专业人员在沟通方面具有优先权,但86.1%的RP声称应该是接受过CST的人。如果放射科医生直接与患者沟通,rp倾向于1。披露应限于放射学报告中的发现(95%);2. 沟通活动应包括强调RP是患者的主要代理(84.1%);和3。沟通应按照协商一致建立的指导方针进行(73.2%)。强烈意见的百分比在年龄、性别、专业领域或总经验年数方面没有显着变化,除了外科医生强烈反对将沟通活动委托给另一位接受CST的卫生专业人员(χ²= 9.9;P = 0.042)。结论本研究结果可作为实施以患者为中心的放射学制度和国家政策的依据。
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引用次数: 12
Cardiac calcified amorphous tumors: CT and MRI findings. 心脏钙化无定形肿瘤:CT和MRI表现。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.16075
R. Yılmaz, A. Demir, İmran Önür, Dilek Yılbazbayhan, M. Dursun
PURPOSEWe aimed to evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings of cardiac calcified amorphous tumors (CATs).METHODSCT and MRI findings of cardiac CATs in 12 patients were included. We retrospectively examined patient demographics, location, size, shape configuration, imaging features, calcification distribution of tumors, and accompanying medical problems.RESULTSThere was a female predominance (75%), with a mean age at presentation of 65 years. Patients were mostly asymptomatic on presentation (58.3%). The left ventricle of the heart was mostly involved (91%). CT findings of CATs were classified as partial calcification with a hypodense mass in four patients or a diffuse calcified form in eight. Calcification was predominant with large foci appearance as in partially calcified masses. On T1- and T2-weighted magnetic resonance images, CATs appeared hypointense and showed no contrast enhancement.CONCLUSIONThe shape and configuration of cardiac CATs are variable with a narrow spectrum of CT and MRI findings, but large foci in a partially calcified mass or diffuse calcification of a mass on CT is very important in the diagnosis of cardiac CATs. Masses show a low signal intensity on T1- and T2-weighted images with no contrast enhancement on MRI.
目的探讨心脏钙化无定形肿瘤(CATs)的计算机断层扫描(CT)和磁共振成像(MRI)表现。方法回顾性分析12例患者的ct和MRI表现。我们回顾性地检查了患者的人口统计学、位置、大小、形状、影像学特征、肿瘤的钙化分布和伴随的医疗问题。结果患者以女性为主(75%),平均发病年龄65岁。大多数患者在就诊时无症状(58.3%)。主要累及左心室(91%)。4例CT表现为部分钙化伴低密度肿块,8例为弥漫性钙化。钙化以部分钙化肿块为主,呈大灶状。在T1和t2加权磁共振图像上,cat表现为低信号,无增强。结论心脏cat的形态多样,CT和MRI表现谱窄,但肿块部分钙化或弥漫性钙化的CT大病灶对心脏cat的诊断有重要意义。肿块在T1和t2加权图像上表现为低信号强度,MRI上无增强。
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引用次数: 19
Cross-sectional imaging of congenital and acquired abnormalities of the portal venous system. 门静脉系统先天性和后天性异常的横断成像。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.16012
M. Özbayrak, S. Tatli
Knowing the normal anatomy, variations, congenital and acquired pathologies of the portal venous system are important, especially when planning liver surgery and percutaneous interventional procedures. The portal venous system pathologies can be congenital such as agenesis of portal vein (PV) or can be involved by other hepatic disorders such as cirrhosis and malignancies. In this article, we present normal anatomy, variations, and acquired pathologies involving the portal venous system as seen on computed tomography (CT) and magnetic resonance imaging (MRI).
了解门静脉系统的正常解剖、变异、先天性和获得性病理是很重要的,特别是在计划肝脏手术和经皮介入手术时。门静脉系统病变可能是先天性的,如门静脉发育不全(PV),也可能与其他肝脏疾病(如肝硬化和恶性肿瘤)有关。在这篇文章中,我们介绍了门静脉系统的正常解剖、变异和获得性病理,包括计算机断层扫描(CT)和磁共振成像(MRI)。
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引用次数: 4
Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae. 模拟颈动脉海绵状瘘的非海绵状动静脉分流术。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.16073
C. Kobkitsuksakul, P. Jiarakongmun, E. Chanthanaphak, S. Pongpech
PURPOSEThe classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages.METHODSWe retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded.RESULTSOf those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction.CONCLUSIONArteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow.
目的颈动脉海绵窦瘘或海绵窦硬膜动静脉瘘(AVF)的典型症状和体征为眼红肿、眼球突出、凝视异常。血管造影典型表现为海绵窦动静脉分流伴眼静脉引流伴或不伴皮质静脉回流。在极少数情况下,分流位于海绵窦外,但类似海绵窦分流的症状和影像学表现。我们想介绍其他位置的动静脉分流,模仿颈动脉海绵状瘘的临床表现,并分析静脉引流。方法回顾性分析2008 - 2014年在曼谷Ramathibodi医院介入神经放射科临时诊断为颈动脉海绵窦瘘或海绵窦硬膜AVF的350例患者的记录。排除海绵状动静脉分流术患者。结果在350例患者中,10例(2.85%)确诊为非海绵窦性房颤。血管造影诊断包括3例前髁(舌下)硬脑膜AVF, 2例外伤性中脑膜AVF, 1例小蝶翼硬脑膜AVF, 1例椎-椎瘘,1例眶内AVF, 1例硬脑膜动脉-硬脑膜皮质静脉直接AVF, 1例横乙状状硬脑膜AVF。6例(60%)出现静脉传出梗阻。结论类似海绵状AVF的动静脉分流是罕见的,发生率仅为2.85%。临床表现以静脉流出为主。根据中枢神经系统和颅底的静脉解剖,动静脉分流的静脉出口受到静脉传入-传出模式的影响,也受到建筑障碍的影响,特别是静脉流出受阻。
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引用次数: 11
Pulmonary adenocarcinomas presenting as ground-glass opacities on multidetector CT: three-dimensional computer-assisted analysis of growth pattern and doubling time. 肺腺癌在多层CT上表现为磨玻璃样混浊:三维计算机辅助分析生长模式和倍增时间。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.16110
A. Borghesi, D. Farina, Silvia Michelini, M. Ferrari, D. Benetti, S. Fisogni, A. Tironi, R. Maroldi
PURPOSEWe aimed to evaluate the growth pattern and doubling time (DT) of pulmonary adenocarcinomas exhibiting ground-glass opacities (GGOs) on multidetector computed tomography (CT).METHODSThe growth pattern and DT of 22 pulmonary adenocarcinomas exhibiting GGOs were retrospectively analyzed using three-dimensional semiautomatic software. Analysis of each lesion was based on calculations of volume and mass changes and their respective DTs throughout CT follow-up. Three-dimensional segmentation was performed by a single radiologist on each CT scan. The same observer and another radiologist independently repeated the segmentation at the baseline and the last CT scan to determine the variability of the measurements. The relationships among DTs, histopathology, and initial CT features of the lesions were also analyzed.RESULTSPulmonary adenocarcinomas presenting as GGOs exhibited different growth patterns: some lesions grew rapidly and some grew slowly, whereas others alternated between periods of growth, stability, or shrinkage. A significant increase in volume and mass that exceeded the coefficient of repeatability of interobserver variability was observed in 72.7% and 84.2% of GGOs, respectively. The volume-DTs and mass-DTs were heterogeneous throughout the follow-up CT scan (range, -4293 to 21928 and -3113 to 17020 days, respectively), and their intra- and interobserver variabilities were moderately high. The volume-DTs and mass-DTs were not correlated with the initial CT features of GGOs; however, they were significantly shorter in invasive adenocarcinomas (P = 0.002 and P = 0.001, respectively).CONCLUSIONPulmonary adenocarcinomas exhibiting GGOs show heterogeneous growth patterns with a trend toward a progressive increase in size. DTs may be useful for predicting tumor aggressiveness.
目的探讨多探头计算机断层扫描(CT)显示磨玻璃样混浊(GGOs)的肺腺癌的生长模式和倍增时间(DT)。方法采用三维半自动软件对22例GGOs肺腺癌的生长模式和DT进行回顾性分析。每个病变的分析是基于在整个CT随访过程中计算体积和质量变化及其各自的dt。三维分割由一名放射科医生在每次CT扫描中进行。同一观察者和另一名放射科医生独立地重复基线和最后一次CT扫描的分割,以确定测量结果的可变性。并分析了病变的CT表现、组织病理学和初始CT表现之间的关系。结果肺腺癌表现为不同的生长模式:一些病变生长迅速,一些生长缓慢,而另一些则在生长、稳定或萎缩之间交替。在72.7%和84.2%的政府间组织中,体积和质量的显著增加分别超过了观察者间变异的可重复性系数。在随访的CT扫描中,体积- dt和质量- dt是不均匀的(范围分别为-4293至21928和-3113至17020天),它们在观察者内部和观察者之间的可变性中等。体积- dt和质量- dt与ggo的初始CT特征无关;然而,在浸润性腺癌中,它们明显较短(P = 0.002和P = 0.001)。结论GGOs肺腺癌呈非均匀生长模式,呈进行性增大趋势。DTs可能有助于预测肿瘤的侵袭性。
{"title":"Pulmonary adenocarcinomas presenting as ground-glass opacities on multidetector CT: three-dimensional computer-assisted analysis of growth pattern and doubling time.","authors":"A. Borghesi, D. Farina, Silvia Michelini, M. Ferrari, D. Benetti, S. Fisogni, A. Tironi, R. Maroldi","doi":"10.5152/DIR.2016.16110","DOIUrl":"https://doi.org/10.5152/DIR.2016.16110","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate the growth pattern and doubling time (DT) of pulmonary adenocarcinomas exhibiting ground-glass opacities (GGOs) on multidetector computed tomography (CT).\u0000\u0000\u0000METHODS\u0000The growth pattern and DT of 22 pulmonary adenocarcinomas exhibiting GGOs were retrospectively analyzed using three-dimensional semiautomatic software. Analysis of each lesion was based on calculations of volume and mass changes and their respective DTs throughout CT follow-up. Three-dimensional segmentation was performed by a single radiologist on each CT scan. The same observer and another radiologist independently repeated the segmentation at the baseline and the last CT scan to determine the variability of the measurements. The relationships among DTs, histopathology, and initial CT features of the lesions were also analyzed.\u0000\u0000\u0000RESULTS\u0000Pulmonary adenocarcinomas presenting as GGOs exhibited different growth patterns: some lesions grew rapidly and some grew slowly, whereas others alternated between periods of growth, stability, or shrinkage. A significant increase in volume and mass that exceeded the coefficient of repeatability of interobserver variability was observed in 72.7% and 84.2% of GGOs, respectively. The volume-DTs and mass-DTs were heterogeneous throughout the follow-up CT scan (range, -4293 to 21928 and -3113 to 17020 days, respectively), and their intra- and interobserver variabilities were moderately high. The volume-DTs and mass-DTs were not correlated with the initial CT features of GGOs; however, they were significantly shorter in invasive adenocarcinomas (P = 0.002 and P = 0.001, respectively).\u0000\u0000\u0000CONCLUSION\u0000Pulmonary adenocarcinomas exhibiting GGOs show heterogeneous growth patterns with a trend toward a progressive increase in size. DTs may be useful for predicting tumor aggressiveness.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.16110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 20
Reproducibility and variability of very low dose hepatic perfusion CT in metastatic liver disease. 极低剂量肝脏灌注CT在转移性肝病中的可重复性和可变性。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.16612
O. M. Topçuoğlu, M. Karçaaltıncaba, D. Akata, M. Özmen
PURPOSEWe aimed to determine the intra- and interobserver agreement on the software analysis of very low dose hepatic perfusion CT (pCT).METHODSA total of 53 pCT examinations were obtained from 21 patients (16 men, 5 women; mean age, 60.4 years) with proven liver metastasis from various primary cancers. The pCT examinations were analyzed by two readers independently and perfusion parameters were noted for whole liver, whole metastasis, metastasis wall, and normal-looking liver (liver tissue without metastasis) in regions of interest (ROIs). Readers repeated the analysis after an interval of one month. Intra- and interobserver agreements were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics.RESULTSThe mean ICCs of all ROIs between readers were 0.91, 0.93, 0.86, 0.45, 0.53, and 0.66 for blood flow (BF), blood volume (BV), permeability, arterial liver perfusion (ALP), portal venous perfusion (PVP) and hepatic perfusion index (HPI), respectively. The mean ICCs of all ROIs between readings were 0.86, 0.91, 0.81, 0.53, 0.56, and 0.71 for BF, BV, permeability, ALP, PVP, and HPI, respectively. There was greater agreement on the parameters measured for the whole metastasis than on the parameters measured for the metastasis wall. The effective dose of all perfusion CT studies was 2.9 mSv.CONCLUSIONThere is greater intra- and interobserver agreement for BF and BV than for permeability, ALP, PVP, and HPI at very low dose hepatic pCT. Permeability, ALP, PVP, and HPI parameters cannot be used in clinical practice for hepatic pCT with an effective dose of 2.9 mSv.
目的:探讨极低剂量肝灌注CT (pCT)软件分析在观察者内部和观察者之间的一致性。方法21例患者共53次pCT检查(男16例,女5例;平均年龄60.4岁,经证实有各种原发肿瘤肝转移。pCT检查由2台读卡器独立分析,记录全肝、全转移、转移壁和外观正常的肝(无转移的肝组织)感兴趣区域(roi)的灌注参数。读者每隔一个月重复一次分析。用类内相关系数(ICC)和Bland-Altman统计来评估观察者内部和观察者之间的一致性。结果阅读人群血流量(BF)、血容量(BV)、渗透性、肝动脉灌注(ALP)、门静脉灌注(PVP)和肝灌注指数(HPI)的平均ICCs分别为0.91、0.93、0.86、0.45、0.53和0.66。所有roi的平均ICCs分别为0.86、0.91、0.81、0.53、0.56和0.71,分别为BF、BV、渗透率、ALP、PVP和HPI。对整个转移的参数测量比对转移壁的参数测量更一致。所有灌注CT研究的有效剂量均为2.9 mSv。结论在极低剂量的肝脏pCT中,BF和BV在观察者内部和观察者之间的一致性高于渗透性、ALP、PVP和HPI,对于有效剂量为2.9 mSv的肝脏pCT,渗透性、ALP、PVP和HPI参数不能用于临床。
{"title":"Reproducibility and variability of very low dose hepatic perfusion CT in metastatic liver disease.","authors":"O. M. Topçuoğlu, M. Karçaaltıncaba, D. Akata, M. Özmen","doi":"10.5152/DIR.2016.16612","DOIUrl":"https://doi.org/10.5152/DIR.2016.16612","url":null,"abstract":"PURPOSE\u0000We aimed to determine the intra- and interobserver agreement on the software analysis of very low dose hepatic perfusion CT (pCT).\u0000\u0000\u0000METHODS\u0000A total of 53 pCT examinations were obtained from 21 patients (16 men, 5 women; mean age, 60.4 years) with proven liver metastasis from various primary cancers. The pCT examinations were analyzed by two readers independently and perfusion parameters were noted for whole liver, whole metastasis, metastasis wall, and normal-looking liver (liver tissue without metastasis) in regions of interest (ROIs). Readers repeated the analysis after an interval of one month. Intra- and interobserver agreements were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics.\u0000\u0000\u0000RESULTS\u0000The mean ICCs of all ROIs between readers were 0.91, 0.93, 0.86, 0.45, 0.53, and 0.66 for blood flow (BF), blood volume (BV), permeability, arterial liver perfusion (ALP), portal venous perfusion (PVP) and hepatic perfusion index (HPI), respectively. The mean ICCs of all ROIs between readings were 0.86, 0.91, 0.81, 0.53, 0.56, and 0.71 for BF, BV, permeability, ALP, PVP, and HPI, respectively. There was greater agreement on the parameters measured for the whole metastasis than on the parameters measured for the metastasis wall. The effective dose of all perfusion CT studies was 2.9 mSv.\u0000\u0000\u0000CONCLUSION\u0000There is greater intra- and interobserver agreement for BF and BV than for permeability, ALP, PVP, and HPI at very low dose hepatic pCT. Permeability, ALP, PVP, and HPI parameters cannot be used in clinical practice for hepatic pCT with an effective dose of 2.9 mSv.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.16612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Radiologic findings of screen-detected cancers in an organized population-based screening mammography program in Turkey. 在土耳其有组织的以人群为基础的筛查性乳房x光检查项目中筛查检测到的癌症的放射学结果。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.15250
A. Kayhan, E. Arıbal, C. Sahin, Ömür Can Taşçı, Sibel Özkan Gürdal, E. Öztürk, H. Hatipoğlu, Nilüfer Özaydın, N. Cabioğlu, Beyza Özçınar, V. Özmen
PURPOSEBahçeşehir Breast Cancer Screening Program is a population based organized screening program in Turkey, where asymptomatic women aged 40-69 years are screened biannually. In this prospective study, we aimed to determine the mammographic findings of screen-detected cancers and discuss the efficacy of breast cancer screening in a developing country.METHODSA total of 6912 women were screened in three rounds. The radiologic findings were grouped as mass, focal asymmetry, calcification, and architectural distortion. Masses were classified according to shape, border, and density. Calcifications were grouped according to morphology and distribution. Cancers were grouped according to the clinical stage.RESULTSSeventy cancers were detected with an incidence of 4.8/1000. Two cancers were detected in other centers and three were not visualized mammographically. Mammographic presentations of the remaining 65 cancers were mass (47.7%, n=31), calcification (30.8%, n=20), focal asymmetry (16.9%, n=11), architectural distortion (3.1%, n=2), and skin thickening (1.5%, n=1). The numbers of stage 0, 1, 2, 3, and 4 cancers were 13 (20.0%), 34 (52.3%), 14 (21.5%), 3 (4.6%), and 1 (1.5%), respectively. The numbers of interval and missed cancers were 5 (7.4%) and 7 (10.3%), respectively.CONCLUSIONA high incidence of early breast cancer has been detected. The incidence of missed and interval cancers did not show major differences from western screening trials. We believe that this study will pioneer implementation of efficient population-based mammographic screenings in developing countries.
目的bahe ehir乳腺癌筛查项目是土耳其一项以人群为基础的有组织筛查项目,40-69岁的无症状妇女每两年进行一次筛查。在这项前瞻性研究中,我们旨在确定筛查检测到的癌症的乳房x光检查结果,并讨论乳腺癌筛查在发展中国家的疗效。方法共对6912名妇女进行三轮筛查。影像学表现为肿块、局灶不对称、钙化和结构扭曲。根据形状、边界和密度对质量进行分类。根据形态和分布对钙化进行分组。肿瘤按临床分期进行分组。结果共检出70例肿瘤,发病率为4.8/1000。两个癌症是在其他中心发现的,三个没有通过乳房x光检查。其余65例肿瘤的x线摄影表现为肿块(47.7%,n=31)、钙化(30.8%,n=20)、局灶不对称(16.9%,n=11)、结构扭曲(3.1%,n=2)和皮肤增厚(1.5%,n=1)。0期、1期、2期、3期和4期肿瘤分别为13例(20.0%)、34例(52.3%)、14例(21.5%)、3例(4.6%)和1例(1.5%)。间隔期癌5例(7.4%),漏诊癌7例(10.3%)。结论早期乳腺癌的发病率较高。漏诊和间隔期癌症的发生率与西方筛查试验没有明显差异。我们相信,这项研究将率先在发展中国家实施有效的基于人群的乳房x线摄影筛查。
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引用次数: 5
Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia. 弥散加权成像在急性淋巴细胞白血病患儿颅骨骨髓浸润检测中的作用。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.15167
Weiguo Cao, C. Liang, Yun-Geng Gen, Chen Wang, Cailei Zhao, Longwei Sun
PURPOSEWe aimed to determine whether diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement can detect skull bone marrow infiltration in newly diagnosed acute lymphoblastic leukemia (ALL) children before therapy and normalization in complete remission after treatment.METHODSFifty-one newly diagnosed acute lymphoblastic leukemia (ALL) patients and 30 healthy age-matched subjects were included. Cranial magnetic resonance imaging (MRI) scans were reviewed, and skull marrow ADC values were compared before treatment and in complete remission after therapy.RESULTSSkull marrow infiltration, manifested with abnormal DWI signals, was present in 37 patients (72.5%) before treatment. Of these, 23 (62.2%) showed scattered signal abnormalities and 14 (37.8%) showed a uniform abnormal signal pattern. Compared with the control group, ADC was significantly decreased in patients with ALL. DWI signal intensity and ADC normalized in patients with complete remission.CONCLUSIONDWI is a useful and noninvasive tool for detecting skull infiltration in ALL children before treatment and normalization at complete remission after therapy, and it is superior to conventional MRI in terms of conspicuity of these lesions. DWI could be used as an MRI biomarker for evaluation of treatment in ALL children.
目的探讨弥散加权成像(DWI)与表观弥散系数(ADC)测量在新诊断急性淋巴细胞白血病(ALL)患儿治疗前及治疗后完全缓解后能否检测颅骨骨髓浸润。方法纳入51例新诊断急性淋巴细胞白血病(ALL)患者和30例年龄匹配的健康受试者。回顾颅脑磁共振成像(MRI)扫描,比较治疗前和治疗后完全缓解的颅骨骨髓ADC值。结果37例(72.5%)患者治疗前出现颅骨骨髓浸润,DWI信号异常。其中23例(62.2%)表现为散在性异常,14例(37.8%)表现为均匀性异常。与对照组相比,ALL患者ADC明显降低。DWI信号强度和ADC在完全缓解患者中恢复正常。结论dwi是一种有效的无创工具,可用于ALL患儿治疗前和治疗后完全缓解后的颅骨浸润检测,在病变的显著性方面优于常规MRI。DWI可作为评估ALL患儿治疗的MRI生物标志物。
{"title":"Role of diffusion-weighted imaging for detecting bone marrow infiltration in skull in children with acute lymphoblastic leukemia.","authors":"Weiguo Cao, C. Liang, Yun-Geng Gen, Chen Wang, Cailei Zhao, Longwei Sun","doi":"10.5152/DIR.2016.15167","DOIUrl":"https://doi.org/10.5152/DIR.2016.15167","url":null,"abstract":"PURPOSE\u0000We aimed to determine whether diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurement can detect skull bone marrow infiltration in newly diagnosed acute lymphoblastic leukemia (ALL) children before therapy and normalization in complete remission after treatment.\u0000\u0000\u0000METHODS\u0000Fifty-one newly diagnosed acute lymphoblastic leukemia (ALL) patients and 30 healthy age-matched subjects were included. Cranial magnetic resonance imaging (MRI) scans were reviewed, and skull marrow ADC values were compared before treatment and in complete remission after therapy.\u0000\u0000\u0000RESULTS\u0000Skull marrow infiltration, manifested with abnormal DWI signals, was present in 37 patients (72.5%) before treatment. Of these, 23 (62.2%) showed scattered signal abnormalities and 14 (37.8%) showed a uniform abnormal signal pattern. Compared with the control group, ADC was significantly decreased in patients with ALL. DWI signal intensity and ADC normalized in patients with complete remission.\u0000\u0000\u0000CONCLUSION\u0000DWI is a useful and noninvasive tool for detecting skull infiltration in ALL children before treatment and normalization at complete remission after therapy, and it is superior to conventional MRI in terms of conspicuity of these lesions. DWI could be used as an MRI biomarker for evaluation of treatment in ALL children.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.15167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71005753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 19
Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings. 剖宫产后骨盆多探头CT表现:正常与异常急性表现。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.15593
B. Gui, F. Danza, A. Valentini, M. Laino, A. Caruso, B. Carducci, E. Rodolfino, E. Devicienti, L. Bonomo
Cesarean section (CS) may have several acute complications that can occur in the early postoperative period. The most common acute complications are hematomas and hemorrhage, infection, ovarian vein thrombosis, uterine dehiscence and rupture. Pelvic hematomas usually occur at specific sites and include bladder flap hematoma (between the lower uterine segment and the bladder) and subfascial or rectus sheath hematoma (rectus sheath or prevescical space). Puerperal hemorrhage can be associated with uterine dehiscence or rupture. Pelvic infections include endometritis, abscess, wound infection, and retained product of conception. Radiologists play an important role in the diagnosis and management of postoperative complications as a result of increasing use of multidetector CT in emergency room. The knowledge of normal and abnormal postsurgical anatomy and findings should facilitate the correct diagnosis so that the best management can be chosen for the patient, avoiding unnecessary surgical interventions and additional treatments. In this article we review the surgical cesarean technique and imaging CT technique followed by description of normal and abnormal post-CS CT findings.
剖宫产(CS)可能有几个急性并发症,可发生在术后早期。最常见的急性并发症是血肿出血、感染、卵巢静脉血栓形成、子宫开裂破裂。盆腔血肿通常发生在特定部位,包括膀胱瓣血肿(子宫下段与膀胱之间)、筋膜下血肿或直肌鞘血肿(直肌鞘或膀胱前间隙)。产后出血可伴有子宫开裂或破裂。盆腔感染包括子宫内膜炎、脓肿、伤口感染和妊娠遗留产物。随着多层螺旋CT在急诊室的应用越来越广泛,放射科医生在术后并发症的诊断和处理中发挥着重要作用。了解正常和异常的术后解剖和发现有助于正确诊断,以便为患者选择最佳治疗方案,避免不必要的手术干预和额外的治疗。在本文中,我们回顾了手术剖宫产技术和CT成像技术,并描述了正常和异常的cs后CT表现。
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引用次数: 13
Local tumor progression patterns after radiofrequency ablation of colorectal cancer liver metastases. 结直肠癌肝转移灶射频消融术后局部肿瘤进展模式。
IF 2.1 4区 医学 Q2 Medicine Pub Date : 2016-11-01 DOI: 10.5152/DIR.2016.15543
Marc Napoleone, A. Kielar, Rebecca M Hibbert, Sameh Saif, B. Kwan
PURPOSEWe aimed to evaluate patterns of local tumor progression (LTP) after radiofrequency ablation (RF ablation) of colorectal cancer liver metastases (CRCLM) and to highlight the percentage of LTP not attributable to lesion size or RF ablation procedure-related factors (heat sink or insufficient ablation margin).METHODSCRCLM treated by RF ablation at a single tertiary care center from 2004-2012, with a minimum of six months of postprocedure follow-up, were included in this retrospective study. LTP morphology was classified as focal nodular (<90° of ablation margin), circumferential (>270°), or crescentic (90°-270°). Initial metastasis size, minimum ablation margin size, morphology of LTP, presence of a heat sink, and time to progression were recorded independently by two radiologists.RESULTSThirty-two of 127 RF ablation treated metastases (25%) with a mean size of 23 mm (standard deviation 12 mm) exhibited LTP. Fifteen of 32 LTPs (47%) were classified as focal nodular, with seven having no procedure-related factor to explain recurrence. Ten of 32 LTPs (31%) were circumferential, with four having no procedure-related factor to explain recurrence. Seven of 32 LTPs (22%) were crescentic, with two having no procedure-related factor to explain recurrence. Of the 13 lesions without any obvious procedure-related reason for LTP, six (46%) were <3 cm in size.CONCLUSIONAlthough LTP in RF ablation treated CRCLM can often be explained by procedure-related factors or size of the lesion, in this study up to six (5%) of the CRCLM we treated showed LTP without any reasonable cause.
目的:我们旨在评估射频消融(RF消融)后结直肠癌肝转移(CRCLM)的局部肿瘤进展(LTP)模式,并强调LTP的百分比不归因于病变大小或射频消融手术相关因素(热沉或消融范围不足)。方法回顾性研究纳入2004-2012年在单一三级医疗中心接受射频消融治疗的scrclm,术后随访至少6个月。LTP形态分为局灶性结节状(270°)或新月形(90°-270°)。最初的转移大小,最小消融边缘大小,LTP的形态,热沉降的存在和进展时间由两名放射科医生独立记录。结果127例经射频消融治疗的转移瘤中32例(25%)出现LTP,平均大小为23 mm(标准差为12 mm)。32例ltp中有15例(47%)被归类为局灶性结节,其中7例没有手术相关因素可以解释复发。32例ltp中有10例(31%)是周向的,4例没有手术相关因素可以解释复发。32例ltp中有7例(22%)为新月形,其中2例没有手术相关因素可解释复发。在13个与LTP无明显手术相关原因的病变中,6个(46%)小于3cm。尽管射频消融治疗CRCLM的LTP通常可以通过手术相关因素或病变大小来解释,但在本研究中,我们治疗的CRCLM中有多达6例(5%)出现了没有任何合理原因的LTP。
{"title":"Local tumor progression patterns after radiofrequency ablation of colorectal cancer liver metastases.","authors":"Marc Napoleone, A. Kielar, Rebecca M Hibbert, Sameh Saif, B. Kwan","doi":"10.5152/DIR.2016.15543","DOIUrl":"https://doi.org/10.5152/DIR.2016.15543","url":null,"abstract":"PURPOSE\u0000We aimed to evaluate patterns of local tumor progression (LTP) after radiofrequency ablation (RF ablation) of colorectal cancer liver metastases (CRCLM) and to highlight the percentage of LTP not attributable to lesion size or RF ablation procedure-related factors (heat sink or insufficient ablation margin).\u0000\u0000\u0000METHODS\u0000CRCLM treated by RF ablation at a single tertiary care center from 2004-2012, with a minimum of six months of postprocedure follow-up, were included in this retrospective study. LTP morphology was classified as focal nodular (<90° of ablation margin), circumferential (>270°), or crescentic (90°-270°). Initial metastasis size, minimum ablation margin size, morphology of LTP, presence of a heat sink, and time to progression were recorded independently by two radiologists.\u0000\u0000\u0000RESULTS\u0000Thirty-two of 127 RF ablation treated metastases (25%) with a mean size of 23 mm (standard deviation 12 mm) exhibited LTP. Fifteen of 32 LTPs (47%) were classified as focal nodular, with seven having no procedure-related factor to explain recurrence. Ten of 32 LTPs (31%) were circumferential, with four having no procedure-related factor to explain recurrence. Seven of 32 LTPs (22%) were crescentic, with two having no procedure-related factor to explain recurrence. Of the 13 lesions without any obvious procedure-related reason for LTP, six (46%) were <3 cm in size.\u0000\u0000\u0000CONCLUSION\u0000Although LTP in RF ablation treated CRCLM can often be explained by procedure-related factors or size of the lesion, in this study up to six (5%) of the CRCLM we treated showed LTP without any reasonable cause.","PeriodicalId":50582,"journal":{"name":"Diagnostic and Interventional Radiology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5152/DIR.2016.15543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
期刊
Diagnostic and Interventional Radiology
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