2016年 · 第50卷第08期

Breast cancer in China has the characteristics of early onset and low screening prevalence. If it can be detected early and treated in time, the 5-year survival rate can reach 70%^[1,2,3]。 Breast imaging is of great value for early detection and early diagnosis of breast cancer. Commonly used breast imaging methods include breast ultrasound, mammography and breast MRI. Mammography has high diagnostic accuracy, low cost, simple operation, and can show masses and small calcifications in the breast. It is the first choice for screening breast diseases. However, the display of dense breast and proximal chest wall mass is poor^[4,5,6,7]。 Breast MRI has high tissue resolution, which can be applied to multi-sequence, multi-parameter, dynamic enhanced scanning methods, etc. It shows the size, shape, number and location of lesions better than other imaging methods^[8]； However, the examination is time-consuming, expensive, and the calcification display is not good, so it is often not the first choice examination method. In order to standardize the breast imaging examination technology and better serve patients, relevant domestic experts drafted this edition of expert consensus on breast imaging examination technology with reference to the latest guidelines and literatures at home and abroad, and combined with the actual clinical situation^{[9,10,11,12,13,14]}。

neuroendocrine carcinoma is a group of malignant tumors originating from the diffuse neuroendocrine system (DNES). Primary mediastinal cancer is rare^[1]The preoperative imaging diagnosis rate is low. The CT findings of 23 patients with primary neuroendocrine carcinoma of mediastinum diagnosed by clinical pathology were collected and analyzed in order to improve the understanding of the imaging findings of this disease and optimize the preoperative imaging diagnosis.

desmoplastic fibroblastoma (DF), also known as sclerosing fibroblastoma or collagen fibroma, is a rare and late-recognized soft tissue tumor. Because the clinical manifestations of this disease are not specific, the misdiagnosis rate is high, and the current literature at home and abroad is mostly a case or a few cases reports, clinicians have insufficient understanding of it. The author collected the data of 5 patients and combined with the literature review to explore the correlation between their imaging manifestations and clinical pathology, aiming at improving the understanding and diagnosis of this disease.

The patient was a 66-year-old female. Intermittent upper abdominal pain and discomfort for 1 month. Abdominal physical examination showed no significant abnormalities.

The patient was a female, 12 years and 5 months old. He was admitted on 06 Nov 2015 due to vaginal bleeding for 26 d. The patient continued after menstrual cramps 26 days ago, with moderate volume, no clots, abdominal pain, nausea and vomiting. Gynecological examination: the vulva developed normally, the vaginal opening was normal and visible, there was no hymen atresia, and a small amount of reddish blood flowed out. The digital rectal examination pressed the vagina to see about 20 ml of reddish blood flowing out, mixed with a small amount of purulent secretion, and the uterus and double appendages were not palpable satisfactorily.

The patient was a 21-year-old female. Due to menopause for 68 days, the left upper abdomen was distended and painful for 1 week. Physical examination: Light tenderness in the left upper abdomen. Gynecological physical examination: the uterus was anterior, normal in size, no tenderness, and no mass was palpable in the bilateral adnexal area. Chorionic gonadotropin increased up to 200 716 mIU/ml.

Energy spectrum CT imaging technology with instantaneous dual-kVP switching as its core is a major change in the history of CT development. It can not only provide CT value, but also provide single energy imaging, energy spectrum curve, matter density map, effective atomic number and other parameters information. At present, it has been gradually applied to all systems in the whole body^[1]。 Energy spectrum CT brings imaging diagnosis from the morphological category to the functional category. It can not only provide high-definition and low-dose imaging, but also provide quantitative analysis indicators and tools for substances. It shows unique advantages for the diagnosis of lung diseases, such as the display of fine structures, the detection of tiny lesions, and the accurate diagnosis of diseases. Therefore, the author reviews the research status and prospect of energy spectrum CT in the diagnosis of pulmonary diseases.