| PART 1 The diagnostic value of dynamic enhancement by low-dose MDCT in breast cancerObjective: To discuss the diagnostic value of low-dose multi-detector computer tomography in breast cancer.Materials and Methods: 70 patients underwent low-dose MDCT dynamic enhancement on Siemens Somatom Sensation 4 scanner, 120kV,50mAs.Contrast injection was done by using 90ml nonionic contrast agent, at a flow rate of 3ml/s with a power injectors, Following plain CT scanning, dynamic enhanced scan initiated at 30s,60s,90s,180s respectively after the contrast agent injection. Multi-planar reconstruction(MPR) were obtained by using the post-processing techniques. All the lesions were evaluated by plain and contrast enhanced MDCT, the morphology manifestation and contrast enhanced patterns were observed and statistically analyzed. Results:①The highest predictive features for malignant tumors were speculated margin,lobular shape and heterogeneous enhancement, respectively 82%,88%,82%.②The distributing of time-density curve were different in breast diseases: type A (77%) and type B (75%) shown in the majority of malignant tumors, type C (62%) and type D (89%) shown in the majority of benign tumors.③There were significant differences between malignant and benign tumors on the dynamic enhanced parameters of E(p < 0.0001),SLOPE(p < 0.0001) and Tmax ( p=0.0018 ).④Morphology manifestation combined with enhanced patterns by low-dose MDCT, the sensitivity,specificity and accuracy were 97%,88%,93% respectively.Conclusion:①Low-dose MDCT could not only provide nice image quality and rich morphology information, but also reveal the blood dynamic characters by contrast enhanced scan, which is helpful to differential diagnosis between benign and malignant tumors.②Morphology manifestation combined with contrast enhanced patterns by low-dose MDCT, the examination accuracy would be improved greatly. PART 2 Change characteristics of breast cancer blood in pre-and post-neoadjuvant chemotherapy with low-dose CT perfusionObjective: To analysis the change characteristic of breast cancer blood in pre-and post-neoadjuvant chemotherapy with low-dose CT perfusion imaging.Materials and Methods: 15 patients with breast cancer underwent CT breast perfusion was performed pre-and post-neoadjuvant chemotherapy within 1 week on Siemens Somatom Sensation 4 scanner, 120kV,50mAs. Contrast injection was done by using 50ml nonionic contrast agent (320mgI/ml), at a flow rate of 4ml/s with a power injectors,8 seconds delay, and data acquisition lasted for 50 seconds. These data were processed using Basama perfusion 3 software package, and the mean BF, BV and MTT were measured and statistically analyzed.Results:①The mean BF,BV and MTT were 33.20±4.17 ml.min.100g-1,8.31±2.43 ml.100g-1,15.31±4.31s respectively before neoadjuvant chemotherapy, and after that, The mean BF,BV and MTT was 13.65±6.04 ml.min.100g-1,5.04±2.33 ml.100g-1,25.97±9.07s respectively. Breast tumors showed significant reduction in BF,BV and increase in MTT. The mean BF,BV and MTT were statistically significant in pre-and post-neoadjuvant chemotherapy(p=0.000).②The mean of BF,BV,MTT were not statistically significant after neoadjuvant chemotherapy in normal breast(p>0.05), but the mean of BF tended to decrease, and the mean of BV,MTT increased slightly after neoadjuvant chemotherapy.③The perfusion parameters were according with literature reports by low-dose,low injection speed scan.Conclusion:①BF and BV decrease corresponding with the tumor size reducing after neoadjuvant chemotherapy.②Blood dynamics changes are earlier than morphology observed by CT perfusion.③After neoadjuvant chemotherapy the BF of the normal breast tissue has the trend to reduce.④Low-dose,low injection speed scan could take place of conventional CT perfusion. |
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