• 제목/요약/키워드: Background parenchymal enhancement

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유방암 환자에서 시행한 유방 자기공명영상에서 배경 실질 조영 증강이 조직검사율과 악성률에 미치는 영향 (Background Parenchymal Enhancement on Breast MRI in Breast Cancer Patients : Impact on Biopsy Rate and Cancer Yield)

  • 김태윤;김성헌;백지은;김윤주;강봉주
    • Investigative Magnetic Resonance Imaging
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    • 제17권3호
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    • pp.224-231
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    • 2013
  • 목적 : 유방암이 진단된 환자에서 시행한 자기공명영상에서 배경 실질 조영 정도에 따른 추가적인 조직 검사율 및 악성률의 차이를 알아 보고자 하였다. 대상 및 방법 : 유방암을 진단받고 유방 자기공명영상을 촬영한 322명의 환자를 대상으로, 2명의 영상의학과 의사가 이들의 유방 자기공명영상을 분석하여 배경 실질 조영 증강 정도를 평가하였으며, 판독지를 통해 추가적인 BI-RADS 범주 4 이상의 병변 유무를 확인하였다. 추가적인 BI-RADS 범주 4 이상의 병변에 대해서는 조직검사를 시행하였고, 악성률을 구하기 위해 조직검사 결과를 확인하였다. 결과 : 총 322명의 유방암 환자의 배경 실질 조영 증강 단계별 환자수는 최소 조영 증강 47.5%, 경한 조영 증강 28.9%, 중간 조영 증강 12.4% 그리고 현저한 조영 증강 11.2%였다. 이 중 70예에서 추가적으로 악성이 의심되는 조영 증강 병변이 발견되었고, 4예를 제외한 66예에서 조직 검사가 시행되었다. 배경 실질 조영 증강이 적은 경우 (최소/경한 조영 증강)와 많은 경우 (중간/현저한 조영 증강) 에 따른 조직 검사율은 각각 19.9%, 22.3%이었고, 악성률은 각각 6.5%, 5.2%이었으나, p-value가 각각 0.77, 0.88로 통계적으로 유의한 차이를 보이지 않았다. 결론 : 유방암이 진단된 환자에서 시행한 자기공명영상에서 배경 실질 조영 정도와 조직 검사율 및 악성률 사이에는 차이가 없었다.

Ultrafast Dynamic Contrast-Enhanced Breast MRI: Lesion Conspicuity and Size Assessment according to Background Parenchymal Enhancement

  • Soo-Yeon Kim;Nariya Cho;Yunhee Choi;Sung Ui Shin;Eun Sil Kim;Su Hyun Lee;Jung Min Chang;Woo Kyung Moon
    • Korean Journal of Radiology
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    • 제21권5호
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    • pp.561-571
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    • 2020
  • Objective: To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCE-MRI by studying lesion conspicuity and size according to the level of background parenchymal enhancement (BPE). Materials and Methods: This study included 360 women (median age, 54 years; range, 26-82 years) with 361 who had undergone breast MRI, including both ultrafast and conventional DCE-MRI before surgery, between January and December 2017. Conspicuity was evaluated using a five-point score. Size was measured as the single maximal diameter. The Wilcoxon signed-rank test was used to compare median conspicuity score. To identify factors associated with conspicuity, multivariable logistic regression was performed. Absolute agreement between size at MRI and histopathologic examination was assessed using the intraclass correlation coefficient (ICC). Results: The median conspicuity scores were 5 at both scans, but the interquartile ranges were significantly different (5-5 at ultrafast vs. 4-5 at conventional, p < 0.001). Premenopausal status (odds ratio [OR] = 2.2, p = 0.048), non-mass enhancement (OR = 4.1, p = 0.001), moderate to marked BPE (OR = 7.5, p < 0.001), and shorter time to enhancement (OR = 0.9, p = 0.043) were independently associated with better conspicuity at ultrafast scans. Tumor size agreement between MRI and histopathologic examination was similar for both scans (ICC = 0.66 for ultrafast vs. 0.63 for conventional). Conclusion: Ultrafast DCE-MRI could improve lesion conspicuity compared to conventional DCE-MRI, especially in women with premenopausal status, non-mass enhancement, moderate to marked BPE or short time to enhancement.

Impact of Radiotherapy on Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging

  • Kim, Yun Ju;Kim, Sung Hun;Choi, Byung Gil;Kang, Bong Joo;Kim, Hyeon Sook;Cha, Eun Suk;Song, Byung Joo
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권7호
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    • pp.2939-2943
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    • 2014
  • Background: While many studies have shown that hormones can influence background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI), only few have directly address the effect of radiotherapy. The purpose of this study was to evaluate the impact of radiotherapy on BPE in breast MRI. Materials and Methods: A retrospective search identified 62 women with unilateral breast cancer who had a breast MRI both before and after radiotherapy following breast-conserving surgery. In our study, we assumed that systemic therapy affected both breasts equivalently. We rated the level of BPE of both breasts using a four-point categorical scale. A change in the level of BPE prior to and after treatment was compared in the diseased and contralateral breasts. Results: All patients received a 4256 to 6480 cGy dose of whole breast radiotherapy over 3-7 weeks. The mean timing of the follow-up study was 6.6 months after completion of radiotherapy. Although the BPE showed a decrease in both breasts after treatment, there was a significant reduction of BPE in the irradiated breast compared with the contralateral breast (1.18 versus 0.98 average reduction in BPE level, p=0.042). Conclusions: Radiotherapy is associated with decrease in BPE with MRI.

Factors Influencing the Background Parenchymal Enhancement in Follow-Up Breast MRI after Adjuvant Endocrine Therapy

  • Youk, Ji Hyun;Son, Eun Ju;Kim, Jeong-Ah
    • Investigative Magnetic Resonance Imaging
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    • 제19권2호
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    • pp.99-106
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    • 2015
  • Purpose: To investigate factors influencing the evaluation of background parenchymal enhancement (BPE) at follow-up breast magnetic resonance imaging (MRI) after adjuvant endocrine therapy. Materials and Methods: One hundred twelve women with breast cancer and MRI of the contralateral unaffected breast before and after endocrine therapy were identified. Two readers in consensus performed blinded side-by-side comparison of BPE (minimal, mild, moderate, and marked) before and after therapy with categorical scales. Age, body mass index, menopausal status, treatment regimen (selective estrogen receptor modulator or aromatase inhibitor), chemotherapy, follow-up duration, BPE at baseline MRI, MRI field strength before and after therapy, and recurrence were analyzed for their influences on decreased BPE. Results: Younger age, premenopausal status, treatment with selective estrogen receptor modulator, MRI field strength, and moderate or marked baseline BPE were significantly associated with decreased BPE. In multivariate analysis, MRI field strength and baseline BPE showed a significant association. Conclusion: MRI field strength and baseline BPE before and after therapy .were associated with decreased BPE at post-therapy, follow-up MRI.

Preliminary study of presumptive intradural-intramedullary intervertebral disc extrusion in 20 dogs

  • Kim, Jaehwan;Kim, Hyoju;Hwang, Jeongyeon;Eom, Kidong
    • Journal of Veterinary Science
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    • 제21권4호
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    • pp.52.1-52.11
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    • 2020
  • Background: Intradural-intramedullary intervertebral disc extrusion (IIVDE) is a rare condition of intervertebral disc disease. However, the diagnosis of IIVDE is challenging because the prognosis and imaging characteristics are poorly characterized. Objectives: We aimed to describe the clinical and imaging characteristics of tentatively diagnosed IIVDE in dogs to assess the prognostic utility of neurological grade and magnetic resonance imaging (MRI) findings. Methods: Twenty dogs were included in this retrospective cohort study. Results: Nonchondrodystrophic breeds (n = 16) were more predisposed than chondrodystrophic breeds. Most dogs showed acute onset of clinical signs. Neurological examination at admission showed predominant non-ambulatory paraparesis (n = 9); paresis (n = 16) was confirmed more frequently than paralysis (n = 4). Follow-up neurological examination results were only available for 11 dogs, ten of whom showed neurological improvement and 8 showed successful outcomes at 1 month. The characteristic MRI findings include thoracic vertebra (T)2 hyperintense, T1 hypointense, intramedullary linear tracts with reduced disc volume, and cleft of the annulus fibrosus. None of the MRI measurements were significantly correlated with neurological grade at admission. Neurological grade did not differ according to the presence of parenchymal hemorrhage, parenchymal contrast enhancement, and meningeal contrast enhancement. Neurological grades at admission showed a statistical correlation with those observed at the 1-month follow-up (r = 0.814, p = 0.02). Conclusions: IIVDE is a rare form of disc extrusion commonly experienced after physical activity or trauma and most frequently affects the cranial-cervical and thoracolumbar regions of nonchondrodystrophic dog breeds. Neurological score at admission emerged as a more useful prognostic indicator than MRI findings in dogs with suspected IIVDE.

Nitrate enhances the secondary growth of storage roots in Panax ginseng

  • Kyoung Rok Geem ;Jaewook Kim ;Wonsil Bae ;Moo-Geun Jee ;Jin Yu ;Inbae Jang;Dong-Yun Lee ;Chang Pyo Hong ;Donghwan Shim;Hojin Ryu
    • Journal of Ginseng Research
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    • 제47권3호
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    • pp.469-478
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    • 2023
  • Background: Nitrogen (N) is an essential macronutrient for plant growth and development. To support agricultural production and enhance crop yield, two major N sources, nitrate and ammonium, are applied as fertilizers to the soil. Although many studies have been conducted on N uptake and signal transduction, the molecular genetic mechanisms of N-mediated physiological roles, such as the secondary growth of storage roots, remain largely unknown. Methods: One-year-old P. ginseng seedlings treated with KNO3 were analyzed for the secondary growth of storage roots. The histological paraffin sections were subjected to bright and polarized light microscopic analysis. Genome-wide RNA-seq and network analysis were carried out to dissect the molecular mechanism of nitrate-mediated promotion of ginseng storage root thickening. Results: Here, we report the positive effects of nitrate on storage root secondary growth in Panax ginseng. Exogenous nitrate supply to ginseng seedlings significantly increased the root secondary growth. Histological analysis indicated that the enhancement of root secondary growth could be attributed to the increase in cambium stem cell activity and the subsequent differentiation of cambium-derived storage parenchymal cells. RNA-seq and gene set enrichment analysis (GSEA) revealed that the formation of a transcriptional network comprising auxin, brassinosteroid (BR)-, ethylene-, and jasmonic acid (JA)-related genes mainly contributed to the secondary growth of ginseng storage roots. In addition, increased proliferation of cambium stem cells by a N-rich source inhibited the accumulation of starch granules in storage parenchymal cells. Conclusion: Thus, through the integration of bioinformatic and histological tissue analyses, we demonstrate that nitrate assimilation and signaling pathways are integrated into key biological processes that promote the secondary growth of P. ginseng storage roots.

Preoperative Magnetic Resonance Imaging Features Associated with Positive Resection Margins in Patients with Invasive Lobular Carcinoma

  • Jiyoung Yoon;Eun-Kyung Kim;Min Jung Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Y. Park
    • Korean Journal of Radiology
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    • 제21권8호
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    • pp.946-954
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    • 2020
  • Objective: To investigate preoperative magnetic resonance imaging (MRI) findings associated with resection margin status in patients with invasive lobular carcinoma (ILC) who underwent breast-conserving surgery. Materials and Methods: One hundred and one patients with ILC who underwent preoperative MRI were included. MRI (tumor size, multifocality, type of enhancing lesion, distribution of non-mass enhancement [NME], and degree of background parenchymal enhancement) and clinicopathological features (age, pathologic tumor size, presence of ductal carcinoma in situ [DCIS] or lobular carcinoma in situ, presence of lymph node metastases, and estrogen receptor/progesterone receptor/human epidermal growth factor receptor type 2 status) were analyzed. A positive resection margin was defined as the presence of invasive cancer or DCIS at the inked surface. Logistic regression analysis was performed to determine pre- and postoperative variables associated with positive resection margins. Results: Among the 101 patients, 21 (20.8%) showed positive resection margins. In the univariable analysis, NME, multifocality, axillary lymph node metastasis, and pathologic tumor size were associated with positive resection margins. With respect to preoperative MRI findings, multifocality (odds ratio [OR] = 3.977, p = 0.009) and NME (OR = 2.741, p = 0.063) were associated with positive resection margins in the multivariable analysis, although NME showed borderline significance. Conclusion: In patients with ILC, multifocality and the presence of NME on preoperative breast MRI were associated with positive resection margins.