医学影像学作为现代医学的重要组成部分，在疾病的临床诊断、术前评估及预测预后等方面发挥着不可或缺的作用，这种无创性的检查方法主要基于放射科医生对医学图像信息的主观判断，因此需要较丰富的临床实践经验。然而，在医学影像学专业学生向放射科医生过渡的过程中，

[目的]分析不同分子亚型乳腺癌的全数字化X线摄影(FFDM)表现,探讨乳腺癌分子亚型与FFDM表现的关系.[方法]对200例乳腺癌患者术前行乳腺FFDM检查,术后采用免疫组化检测,依据ER、PR、HER-2表达情况分为4种分子亚型,观察不同分子亚型乳腺癌的FFDM表现,并分析乳腺癌分子亚型与FFDM表现的关系.[结果]200例乳腺癌中单纯肿块型83例(41.5％),单纯钙化型39例(19.5％),肿块伴钙化型64例(32.0％),局部密度增浓型14例(7.0％).Luminal A型78例(39.0％),Luminal B型54例(27.0％),HER-2型43例(21.5％),Basal-like型25例(12.5％).Luminal A型和Luminal B型主要表现为单纯肿块型(57.7％和51.9％),HER-2型主要表现为单纯钙化型(48.8％),Basal-like型主要表现为肿块伴钙化型(40.0％).统计学结果显示,不同分子亚型乳腺癌的FFDM表现差异有统计学意义(P＜0.05).[结论]乳腺癌的分子亚型与FFDM表现之间有一定的相关性.

Objective:To investigate the clinical value of pretreatment surgical magnetic resonance images (MRI) in the preoperative staging of laryngeal carcinoma.Methods:114 patients with laryngeal carcinoma diagnosed by electrical laryngoscope were studied by pretreatment surgical MRI examinatio.According to the images the tumor and lymphadenopathy were investigated,and the classification and staging of tumor were compared with pathological results.Results:27 cases of T1 were confirmed by MRI,in which 25 cases were confirmed by pathology; 2 cases were T2,and the accuracy ofT1 staging was 92.6％; 39 cases ofT2 were confirmed by MRI,in which 35 cases were confirmed by pathology,3 cases were T1,1 case was T3,and the accuracy ofT2 staging was 89.7％; 29 cases of T3 were confirmed by MRI,in which 25 cases were confirmed by pathology,4 cases were T2,and the accuracy ofT3 staging was 86.2％; 17 cases ofT4 were confirmed by MRI,in which 15 cases were confurmed by pathology,2 cases were T3,and the accuracy ofT4 staging was 88.2％,and the accuracy ofT staging was 87.7％.In preoperative N staging,N1 was 81.8％,while N2 was 94.1％.Conclusion:MRI can display tumor infiltration and lymph node metastasi,which could be considered as a helpful diagnostic method that can contribute to the preoperative staging of laryngeal tumor and further clinical decision made in these patients.

Objective To investigate the correlation of extent and pattern of computed tomography ( CT) enhancement of tumor lesions and histological types in advanced gastric carcinoma .Methods A total of 121 ca-ses of advanced gastric carcinoma were included in this study .Tri-phase enchanced 64-slice spiral CT scan-ning was performed before operation for every patient .We judged the extent lesions′of and pattern of enhance-ment using axial images combined with reconstruction of VR ,MPR and MIP.Then the radiographic result of every subject was compared with its corresponding postoperative histological type after operation .Results In the pres-ent study,the correlation of extent of CT enhancement of tumor lesions and histological types were as follows :ade-nocarcinoma patients were mostly with moderate enhancement ( n=57,61.3%),mucinous adenocarcinoma pa-tients were mostly with mild enhancement (n=7,46.7%).While obvious enhancement were mostly observed in patients with signet ring cell carcinoma(n=8,61.5%).The correlation of pattern of CT enhancement of tumor lesions and histological types were as follows:adenocarcinoma patients were mostly with well -distributed en-hancement(n=58,62.4%),while endothecium obvious enhancement were mostly seen in patients with mucinous adenocarcinoma(n=13,86.7%)and signet ring cell carcinoma (n=7,58.3%).Conclusions There are signif-icant correlation between advanced gastric carcinoma′s tri-phases enhancement characteristics with 64-slice spiral CT and its histological types .Judging histological type using 64-slice spiral CT before operation is useful for formulating and optimizing the therapeutic regimen for gastric cancer patients ,and it is significant for observing the tumors′biological behavior and judging the curative effect .

Objective: To analyze the value of MRI images combined with proton magnetic resonance spectroscopy(1H-MRS) in diagnosis,classification and differential diagnosis of gliomas.Methods: Thirty-four cases of MRI according with glioma patients who were carried out 1H-MRS examination(NAA,Cho,Cr,Lac,Lip and mI wave) were analyzed comprehensively.Results: 1H-MRS showed that,compared with normal brain essence,NAA decreased,Cho increased,and Cr changed little in total,and they had no regularity.The abnormal Lac and(or) Lip peak appeared in part lesions area,mI descended mildly,and Cho increased in tumor surrounding area of lesions area.Conclusion: There is a great value of MRI image combined with 1H-MRS analysis in classification,diagnosis,scope confirmation and differential diagnosis of cerebral gliomas.This technology can effectively improve the diagnosis accuracy of cerebral gliomas.

目的 探讨BI-RADS 3-4级乳腺X线表现与病理诊断的相关性.方法 回顾分析75例患者共88个病灶的X线钼靶评估为BI-RADS3-4级病灶的影像征象,分别统计各影像征象与良恶性之间的关系,运用Logistic回归进一步分析.结果 病变类型、边缘、形态、钙化形态及淋巴结情况与病变良恶性之间均有统计学差异(P＜0.05).腺体型、密度、毛刺、病灶最大径、钙化有无和钙化分布与病变良恶性之间均无统计学意义(P＞0.05).Logistic回归分析进一步得出边缘的OR(1.859)取值最大,95%可信区间(95%CI)1.032~3.347,P=0.039,差异有统计学意义.结论 BI-RADS 3-4级X线表现中病灶的类型、边缘、形态、钙化形态及淋巴结情况对于良恶性的鉴别有意义,其中病灶边缘与良恶性分组显著相关.

目的 研究螺旋CT三维重建技术对非小细胞肺癌放射治疗靶区勾画准确性的影响.方法 应用螺旋CT扫描,图像后处理应用TOMOCON图像融合系统.对肺内病灶分别以常规二维CT及二维CT结合螺旋CT三维重建技术进行肿瘤靶区勾画、体积计算及靶区横径及纵径比较.结果 48例肺癌病人CT定位扫描后常规二维CT靶区勾画结果:靶区体积(GTV)18.85~380.63cm3,中位体积103.60cm3;二维CT结合螺旋CT三维重建勾画结果:靶区体积(GTV)24.05~420.57cm3,中位体积130.55cm3.两组数据经配对t检验,分析结果 P=0.037,有统计学意义.两组勾画结果 显示横径平均差异为(1.5±0.5)mm.纵径平均差异为(3.0±1.5)mm.结论 螺旋CT三维重建技术在肺癌放射治疗靶区勾画中的应用价值是值得肯定的.可以作为常规CT横断面扫描图像勾画的一个有力补充,使得肺癌放射治疗靶区勾画的准确性大大提高.