数字乳房X片中的伪彩色增强应用

利用数字图像处理中伪彩色理论,讨论了灰度一彩色变换函数,并用合适的线性变换函数对数字乳房X片进行处理。处理后的图像与原数字灰度图像相比较,可分辨性明显提高。可以利用这种变换,辅助医疗诊断,从而降低乳房癌的漏诊和误诊率。经验证,经过伪彩色增强后的数字乳房X片病灶区域的可分辨性明显优于原数字图像,有较高的临床价值。     

基于模糊C均值和小波多分辨分析的数字乳房X射线片钙化点提取算法研究

目的为了使临床医生从数字乳房X片图像中得到更准确的钙化点信息,利用模糊C均值聚类算法（Fuzzy Cmeans,FCM）和小波多分辨分析算法,分两步提取出原图中的疑似钙化亮点。第一步是提取较亮区域;第二步是提取亮点簇。提取出亮点的图像可为医生进一步诊断提供依据。     

应用改良传统双环法乳房悬吊术矫治乳房下垂

目的:探讨应用改良传统双环法行乳房悬吊术的方法矫治乳房下垂效果。方法:在传统的双环形切口乳房缩小整形术的基础上在皮肤与乳腺的腺体表面之间行广泛剥离后,在乳腺的下半象限正中将腺体垂直切开,将形成的两部分乳腺复合组织瓣向内上及外上方向旋转后互相交叉重叠缝合固定成形,并将乳晕内外环的真皮行荷包缝合。术后将乳房塑形包扎。结果:应用改良传统双环法行乳房悬吊术的方法矫治乳房下垂13例,术后乳房外形美观持久,乳头、乳晕感觉良好,效果满意。结论:应用改良传统手术方法其技术简便易行,组织损伤小,瘢痕不明显,是矫治轻、中度乳房下垂的一种比较理想的方法,值得推广应用。     

泰州市奶牛乳房炎调查及其病原菌的分离

奶牛乳房炎是奶牛场的常发病和难以防治的疾病,为进一步了解引起奶牛乳房炎的病原微生物,本研究通过对泰州市3个奶牛场572头泌乳牛的乳房炎发病率进行了调查并对乳房炎主要病原菌进行分离和鉴定。结果表明,奶牛临床型乳房炎的发病率为7.69%,隐性型乳房炎发病率为56.64%,乳区阳性率为33.8%,其中临床型:隐性=1:7.36。从65份确定患有乳房炎的奶样中共分离获得8种细菌、156株分离株,且引起乳房炎的主要病原菌是金黄色葡萄球菌和表皮葡萄球菌,其次是停乳链球菌、大肠杆菌、乳房链球菌和无乳链球菌,其检出率分别为42.31%、23.08%、8.97%、6.41%、5.13%和1.28%。该项调查结果初步明确了泰州市乳房炎发病情况,同时为进一步综合防治奶牛乳房炎和研制乳房炎治疗药物提供了科学依据。     

用转移因子治疗159例奶牛乳房炎的效果观察

本文报道了在国内首次用转移因子制剂治疗奶牛隐性乳房炎的效果。我们采用的转移因子制剂是本单位从健康猪脾细胞提取的,经按人用转移因子制检规程检测达到要求后,用于本省西部、东部和郊区三个奶牛场计159头患隐性乳房炎的奶牛,每天一次肌注,连续用药5次,测定用药前后的客观指标(CMT、BTB、苛性钠及氯化物凝乳试验等),以痊愈、显效、好转及无效等判定标准,经统计学处理后看出,用药后与用药前比较,差异非常显著(P<0.01),治疗组的有效率为91.2％,看出了应用转移因子治疗奶牛隐性乳房炎具有明显的治疗效果。     

乳房肥大乳腺组织中泌乳素及其受体的表达

目的:研究泌乳素(PRL)及其受体(PRLR)在乳房肥大和正常体积乳房中的表达情况,探讨乳腺组织中PRL、PRLR的表达与乳房肥大的相关性,为乳房肥大的治疗提供方向。方法:收集2013年1月~2013年4月第四军医大学西京医院26例乳房肥大患者和16例因单纯乳房下垂行乳房悬吊术患者的乳腺组织,采用免疫组织化学法检测乳腺组织标本中PRL和PRLR的表达。结果:PRL在乳房肥大组和正常体积乳房组乳腺组织中的阳性细胞率分别为88.46℅和56.25℅,两组比较差异有统计学意义(P0.05),且两组的PRL阳性的细胞面积、平均光密度值和累积光密度值均有统计学差异(P0.05)。乳房肥大组和正常体积乳房组乳腺组织中PRLR的阳性细胞率分别为76.92℅和75.00℅,两组比较无明显的统计学差异(P0.05),且两组间的PRLR阳性的细胞面积、平均光密度值、累积光密度值均无明显的统计学差异(P0.05)。结论:乳房肥大的发生可能与乳腺组织中泌乳素的表达升高有关,而与乳腺组织中泌乳素受体的表达无关。     

即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后的运用分析

目的：探讨分析即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后的运用。方法：回顾性分析我院2008年2月-2012年4月收治的乳腺癌术后患者106例,采用乳癌术即时扩展型背阔肌肌皮瓣乳房再造保留乳头乳晕复合体,观察手术效果以及满意度。结果：术后患者乳房美容优良率为88．68％明显大于对照组的47．17％,并且术后6个月治疗组生活质量评价总分明显大于对照组总分术后6个月患者生活质量评价总分明显大于术前评价总分,差异具有条件下意义（P〈0．05）,差异均具有统计学意义（P〈0．05）。结论：即时扩展型背阔肌肌皮瓣乳房再造在保留乳头乳晕复合体乳癌术后患者乳房美容效果较好,提高患者生活质量高,值得在临床上推广,但在手术后需积极处理可能存在的并发症情况。     

奶牛乳房炎防治技术研究分析

奶牛乳房炎是奶牛的常见病之一,更是影响其养殖业发展、奶产品质量的重要原因。因此在奶牛的养殖中一定要从各个环境入手加强对奶牛乳房炎的防治。本文分析了奶牛乳房炎的发生原因及预防方法,为提升生产技术,保证奶产品的质量提供参考。     

女性乳房血供及神经支配的应用解剖进展

乳房作为女性身体的一个重要器官,不仅具有孕育生命的作用,更是女性形体美最显著的标志。然而由于各种原因导致女性乳房的形态千差万别,这不仅严重影响了女性的形体美,而且会对女性带来各种轻重程度不等的身体不适,更严重者甚至会对女性的心理健康造成极大的影响。这就需要整形外科医生通过乳房整形手术重新塑造女性乳房的形态美。由于术后易发生皮瓣及乳头乳晕血供障碍、乳头乳晕区域支配神经的损伤以及乳房形态不佳,使得巨乳缩小整形术具有手术难度大,手术风险高,术后患者满意度较差的特点,成为乳房整形手术中的一大难点。究其原因,我们对于女性乳房的血供和神经支配,尤其是乳房内血管神经的具体走行和分支仍然未能了解得十分清晰。因此,开展乳房血供及神经支配的应用解剖研究,对于改良目前的乳房整形手术特别是巨乳缩小整形术术式,以降低手术相关并发症的发生率,具有及其重要的临床指导意义。本文主要从乳房的血供和神经支配两个方面,对乳房的应用解剖进展进行综述。     

多排螺旋CT扫描对骨折的诊断

目的: 普通X线片及CT平扫对于骨折,尤其是隐匿性骨折检出率较低,较易造成漏诊和误诊,随着多排螺旋CT的普及,利用曲面重建(MPR)和容积再现(VR)技术后处理图像,成为诊断隐匿性骨折的理想的影像诊断手段.探讨多排螺旋CT在对骨折的诊断中的临床应用价值。方法: 对213例临床怀疑骨折的患者进行CR摄片再进行多排螺旋CT扫描,通过三维重建技术处理后,得到受检部位二维、三维的图像。结果: 相同的对照组经多排螺旋CT、X线检查检查后,新增33例骨折。结论: 多排螺旋CT扫描及三维重建技术较传统X线平片能对骨折病例做出更正确的诊断。     

Capacities of digital mammography in screening

The purpose of the study was to estimate the capacities of digital mammography in screening in women followed up by a mammologist in the Surgut Clinical Perinatal Center. The results of analog and digital mammography were compared using a Senographe DS in 1772 subjects who had been followed up by a mammologist in the Surgut Clinical Perinatal Center for 3-7 years. Females in whom mammography was first made as a basic study on a digital mammography were identified in an individual group of 887 subjects. Analysis of the capacities of analog and digital mammography indicated many advantages of the latter.     

Characterization of the imaging settings in screening mammography using a tracking and reporting system: A multi-center and multi-vendor analysis

A tracking and reporting system was developed to monitor radiation dose in X-ray breast imaging. We used our tracking system to characterize and compare the mammographic practices of five breast imaging centers located in the United States and Brazil. Clinical data were acquired using eight mammography systems comprising three modalities: computed radiography (CR), full-field digital mammography (FFDM), and digital breast tomosynthesis (DBT). Our database consists of metadata extracted from 334,234 images. We analyzed distributions and correlations of compressed breast thickness (CBT), compression force, target-filter combinations, X-ray tube voltage, and average glandular dose (AGD). AGD reference curves were calculated based on AGD distributions as a function of CBT. These curves represent an AGD reference for a particular population and system. Differences in AGD and imaging settings were attributed to a combination of factors, such as improvements in technology, imaging protocol, and patient demographics. The tracking system allows the comparison of various imaging settings used in screening mammography, as well as the tracking of patient- and population-specific breast data collected from different populations.     

Dual-energy contrast-enhanced digital mammography: Glandular dose estimation using a Monte Carlo code and voxel phantom

PurposeTo estimate the mean glandular dose of contrast enhanced digital mammography, using the EGSnrc Monte Carlo code and female adult voxel phantom.MethodsAutomatic exposure control of full field digital mammography system was used for the selection of the X-ray spectrum and the exposure settings for dual energy imaging. Measurements of the air-kerma and of the half value layers were performed and a Monte Carlo simulation of the digital mammography system was used to compute the mean glandular dose, for breast phantoms of various thicknesses, glandularities and for different X-ray spectra (low and high energy).ResultsFor breast phantoms of 2.0–8.0 cm thick and 0.1–100% glandular fraction, CC view acquisition, from AEC settings, can result in a mean glandular dose of 0.450 ± 0.022 mGy −2.575 ± 0.033 mGy for low energy images and 0.061 ± 0.021 mGy – 0.232 ± 0.033 mGy for high energy images. In MLO view acquisition mean glandular dose values ranged between 0.488 ± 0.007 mGy – 2.080 ± 0.021 mGy for low energy images and 0.065 ± 0.012 mGy – 0.215 ± 0.010 mGy for high energy images.ConclusionThe low kV part of contrast enhanced digital mammography is the main contributor to total mean glandular breast dose. The results of this study can be used to provide an estimated mean glandular dose for individual cases.     

Prevalence of Coronary Artery Disease Evaluated by Coronary CT Angiography in Women with Mammographically Detected Breast Arterial Calcifications

To assess the correlation between breast arterial calcifications (BAC) on digital mammography and the extent of coronary artery disease (CAD) diagnosed with dual source coronary computed tomography angiography (CTA) in a population of women both symptomatic and asymptomatic for coronary artery disease. 100 consecutive women (aged 34 – 86 years) who underwent both coronary CTA and digital mammography were included in the study. Health records were reviewed to determine the presence of cardiovascular risk factors such as hypertension, hyperlipidemia, diabetes mellitus, and smoking. Digital mammograms were reviewed for the presence and degree of BAC, graded in terms of severity and extent. Coronary CTAs were reviewed for CAD, graded based on the extent of calcified and non-calcified plaque, and the degree of major vessel stenosis. A four point grading scale was used for both coronary CTA and mammography. The overall prevalence of positive BAC and CAD in the studied population were 12% and 29%, respectively. Ten of the 12 patients with moderate or advanced BAC on mammography demonstrated moderate to severe CAD as determined by coronary CTA. For all women, the positive predictive value of BAC for CAD was 0.83 and the negative predictive value was 0.78. The presence of BAC on mammography appears to correlate with CAD as determined by coronary CTA (Spearman’s rank correlation coefficient = 0.48, p<.000001). Using logistic regression, the inclusion of BAC as a feature in CAD predication significantly increased classification results (p=0.04).     

Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

Objective

To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program.

Methods

A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared.

Results

Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10^th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20^th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term.

Conclusions

Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.     

Interval cancers as related to frequency of recall to assessment in the South Australian population-based breast screening program: An exploratory study

Australian accreditation standards specify upper limits for percentages of women recalled for further assessment following screening mammography. These limits have been unchanged since national screening commenced circa 1990, although screening target ages have changed, and technology from analogue to digital mammography. This study compared 2804 women with interval cancers diagnosed since national screening began (cases) with 14,020 cancer-free controls (5 controls per case), randomly selected after matching by age, round, screen type and calendar year of screening episode, to determine the odds of interval cancer by differences in clinic recall to assessment percentages. Within low numbers of recalls that were within accepted accreditation ranges, results did not indicate more frequent recalls to assessment to be associated with fewer interval cancers in the analogue era. However, more frequent recalls were associated with reduced interval cancers for digital screens. These results are not conclusive, requiring confirmation in other screening environments, especially those with larger numbers of digital screens. If confirmed, frequency of recalls to assessment may need adjustment to get the best trade-offs in the digital era between reduced odds of interval cancers from more recalls and increases in financial and non-financial costs, including increased potential for overdiagnosis.     

Optimal photon energy comparison between digital breast tomosynthesis and mammography: A case study

A comparison, in terms of the optimal energy that maximizes the image quality between digital breast tomosynthesis (DBT) and digital mammography (DM) was performed in a MAMMOMAT Inspiration system (Siemens) based on amorphous selenium flat panel detector. In this paper we measured the image quality by the signal difference-to-noise ratio (SDNR), and the patient risk by the mean glandular dose (MGD). Using these quantities we compared the optimal voltage that maximizes the image quality both in breast tomosynthesis and standard mammography acquisition mode. The comparison for the two acquisition modes was performed for a W/Rh anode filter combinations by using a 4.5 cm tissue equivalent mammography phantom. Moreover, in order to check if the used equipment was quantum noise limited, the relation of the relative noise with respect to the detector dose was evaluated. Results showed that in the tomosynthesis acquisition mode the optimal voltage is 28 kV, whereas in standard mammography the optimal voltage is 30 kV. The automatic exposure control (AEC) of the system selects 28 kV as optimal voltage both for DBT and DM. Monte Carlo simulations showed a qualitative agreement with the AEC selection system, since an optimal monochromatic energy of 20 keV was found both for DBT and DM. Moreover, the check about the noise showed that the system is not completely quantum noise limited, and this issue could explain the experimental slight difference in terms of optimal voltage between DBT and DM. According to these results, the use of higher voltage settings is not justified for the improvement of the image quality during a DBT examination.     

Dexamethasone-loaded hydroxyapatite enhances bone regeneration in rat calvarial defects

A combination of bioceramics and osteogenic factors is potentially useful for bone regeneration applications. In the present study, hydroxyapatite particles (HA) were loaded with dexamethasone (Dex) and then characterized using SEM and drug release study. The bone regeneration ability of Dex-loaded HA (Dex/HA) was investigated in a rat critical size bone defect using digital mammography, multislice spiral-computed tomography (MSCT) imaging, and histological analysis. The HA and Dex/HA showed nano and micro-scale morphology with a nearly homogenous distribution of diameter. In addition, about 90 % of the drug was released from Dex/HA over a period of three days. After 8 weeks of implantation in rat calvarial defects, no sign of inflammation or complication was observed at the site of surgery. According to digital mammography and MSCT, Dex/HA showed the highest bone regeneration in rat bone defects compared to those received drug-free HA. Histological studies confirmed these data and showed osteointegration to the surrounding tissue. Taking all together, it was demonstrated that Dex/HA can be used as an appropriate synthetic graft for bone tissue engineering applications. These newly developed bioceramics can be used as new bone graft substitutes in orthopaedic surgery and is capable of enhancing bone regeneration.     

全数字化X线摄影联合MR 动态增强检查诊断早期乳腺癌的 临床价值研究

摘要目的：分析早期乳腺癌的全数字X 线摄影与MRI影像学表现,评价全数字X 线摄影联合MRI 检查在早期乳腺癌诊断中的 临床价值。方法：回顾性分析2009 年10 月至2012 年5月在我院经穿刺或手术病理证实为早期乳腺癌的42例患者的临床资料, 术前均行数字X线及动态增强MR 检查,比较两种方法单独使用和联合使用的诊断乳腺癌的准确率。结果：全数字化X 线摄片 诊断早期乳腺癌的准确率为69.0%(29/42),动态增强MR 检查为95.2%(40/42),两者比较差异有统计学意义(P<0.05);两者联合使 用诊断早期乳腺癌的准确率为97.6%(41/42)。结论：动态增强MR 检查对早期乳腺癌的诊断价值明显优于全数字X线摄影,但后 者对微小钙化显示较好,两者联合可提高诊断正确率,尤其对多腺体型和致密型乳腺的早期乳腺癌的检出具有重要的价值。     

全数字化X线摄影联合MR动态增强检查诊断早期乳腺癌的临床价值研究

目的：分析早期乳腺癌的全数字X线摄影与MRI影像学表现,评价全数字X线摄影联合MRI检查在早期乳腺癌诊断中的临床价值。方法：回顾性分析2009年10月至2012年5月在我院经穿刺或手术病理证实为早期乳腺癌的42例患者的临床资料,术前均行数字X线及动态增强MR检查,比较两种方法单独使用和联合使用的诊断乳腺癌的准确率。结果：全数字化X线摄片诊断早期乳腺癌的准确率为69．0％（29／42）,动态增强MR检查为95．2％（40／42）,两者比较差异有统计学意义（P〈0．05）;两者联合使用诊断早期乳腺癌的准确率为97．6％（41／42）。结论：动态增强MR检查对早期乳腺癌的诊断价值明显优于全数字X线摄影,但后者对微小钙化显示较好,两者联合可提高诊断正确率,尤其对多腺体型和致密型乳腺的早期乳腺癌的检出具有重要的价值。