Wei Chou Chang

Ultrasonographic alterations associated with the dilatation of mammary ducts: feature analysis and BI-RADS assessment

ObjectiveThe purpose of this study was to analyse the lesion characteristics and the patterns of dilated ducts on ultrasonography (US) to determine the appropriateness of the Breast Imaging Reporting and Data System (BI-RADS) categories.Materials and methodsFrom July 2001 to June 2006, 172 consecutive pathologically proved lesions with dilated ducts on US were reviewed retrospectively. All the lesions were classified into four types according to their US features, and in combination with the size, location, margins and number of lesions, the corresponding positive predictive values (PPVs) were obtained.ResultsOf the 172 lesions, 55 (32%) were classified as type I, 68 (40%) as type II, 14 (8%) as type III and 35 (20%) as type IV. The PPVs for malignancy were 9% for type I, 13% for type II, 43% for type III and 17% for type IV. There was a significantly higher frequency of malignancy among type III lesions than among type I (43% vs 9%, respectively, P = 0.002; χ2 test) or type II lesions (43% vs 13%, respectively, P = 0.009; χ2 test). Lesions with a nonsubareolar location and noncircumscribed margins had a high probability of malignancy (P < 0.001 and P = 0.03, respectively).ConclusionThe four types of US classifications used in our study establish reliable references for the dilated duct patterns when stratified according to BI-RADS categories, and they clarify the indications for biopsy of these lesions.

Solitary intraosseous neurofibroma of the tibia

A solitary intraosseous neurofibroma is rare and mostly occurs in the mandible. We report a case of a solitary intraosseous neurofibroma of the tibia. The radiographic findings were nonspecific and showed an eccentrically located, osteolytic lesion with a thin sclerotic border in the diaphysis of the left proximal tibia. The entity of intraosseous neurofibroma is briefly reviewed.

Correlation of High-Resolution CT, Symptoms, and Pulmonary Function in Patients During Recovery From Severe Acute Respiratory Syndrome

Study objectives: Little is known of the nature of the recovery period after severe acute respiratory syndrome (SARS) infection. We hypothesized that structural changes of the lung might correlate with symptoms and pulmonary function. To answer this question, we correlate findings of high-resolution CT (HRCT) with dyspnea scores and results of pulmonary function tests in patients during recovery from SARS. Design: Retrospective follow-up cohort study. Setting: University hospital. Patients: Nineteen patients who recovered from SARS-related hospitalization. Measurements: The study included HRCT scores (0 to 100), dyspnea scores (1 to 4), static and dynamic lung volumes, and diffusing capacity of the lung for carbon monoxide (Dlco). Results: The interval between hospital discharge and HRCT study or functional assessment was 31.2 ± 4.8 days (range, 25 to 38 days) [mean ± SD]. All patients had HRCT abnormalities and were assigned to two groups: ground-glass opacity (GGO) only (n = 7, 36.8%) and GGO with fibrosis (GGO+F) [n = 12, 63.2%]. Most patients (16 of 19, 84.2%) had no zonal predominance. HRCT scores correlated well with dyspnea scores (r = 0.78, p < 0.01) and with a variety of pulmonary functional variables, with Dlco being the most significant (r = − 0.923, p < 0.001). Compared with the GGO group, the GGO+F group showed significantly lower FEV1, FVC, total lung capacity, residual volume, and Dlco. Conclusions: HRCT findings correlate well with functional studies and clinical symptoms during recovery from SARS. Longer-term follow-up studies in a larger cohort of patients should be performed to investigate the clinical outcome of recovered SARS patients.