Background:That breast carcinoma is the most common malignant lesion in women. This study aimed to differentiate benign from malignant breast lesions and to predict grading of the latter by comparing the diagnostic value of different parameters in intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI).Materials and methods:Retrospective analysis was performed utilizing imaging and pathological data from 112 patients with 124 breast lesions that underwent IVIM-DWI examination with 3.0 T MRI. Out of 124, 47 benign and 77 malignant lesions were confirmed by pathological diagnosis. The diagnostic performance of f, D, and D∗ value to distinguish benign from malignant breast lesions, was evaluated using pathological results as the gold standard. Correlation between D value and Ki-67 index was evaluated to predict grading of malignant breast lesions.Results:The D value (0.99 ± 0.21) of patients with malignant lesions was significantly lower than that (1.34 ± 0.18) of patients harboring benign lesions (P = .00). The D∗ value (7.60 ± 2.10) in malignant lesion group was higher than that (6.83 ± 2.13) of the benign lesion group (P = .113). The f value (8.50 ± 2.13) in malignant lesion group was remarkably higher than that (7.68 ± 1.98) of benign lesion group (P = .035). For differential diagnosis of benign from malignant breast lesions, optimal diagnostic threshold of D value and f value were 1.21 and 7.86, respectively. The areas of D and f values under the ROC curve were 0.883 and 0.601, respectively. The sensitivity, specificity, and accuracy of D value were 83.0%, 86.7%, and 85.5%, respectively. Accordingly, those indexes of f value were 64.9%, 57.4%, and 62.1%, respectively. Furthermore, the Ki-67 staining index of malignant lesions was robustly negatively correlated with D value (r = −0.395, P < .01).Conclusion:Concrete parameters of IVIM-DWI can help to improve the specificity and accuracy in differential diagnosis of breast benign and malignant lesions. D value is most relevant and valuable in predicting the grading of malignant breast lesions.

Rationale:Inflammatory myofibroblastic tumor (IMT) is a rare type of mesenchymal tumor. IMT can arise in multiple anatomic locations. IMT of the lumbar spinal canal is exceptionally rare.Patient concerns:Here, we report the case of a 56-year-old male patient with an IMT who was in good health until 1 year prior to admission, when he began experiencing pain in both lower extremities and the lower back.Interventions:A space-occupying lesion in the lumbar canal was identified by magnetic resonance imaging and then surgically resected.Diagnoses:Histopathological analysis of the lesion revealed a composition of mucous edema, inflammatory cells, collagenous fibers, and spindle cells that were diffuse and positive for smooth muscle actin and CD68; focal positive for vimentin and desmin; and negative for CD34 (marker of vascular endothelial cells), CD21, CD23, CD35, S-100, Epstein–Barr virus infection, Ki-67, and anaplastic lymphoma kinase. Thus, the diagnosis was an IMT of the lumbar canal.Outcomes:In the spinal canal, IMT should be considered in the evaluation of tumors although it is a very rare diagnosis. It is a benign lesion, but it has potential for invasion and recurrence.Lessons:There are no characteristic imaging features of these tumors, but they can be addressed by complete surgical excision. Patients with these lesions should undergo frequent long-term follow-up to detect and address recurrence.

BACKGROUND AND PURPOSE:The virtual noncontrast images generated with iodine subtraction from dual-energy CTA images are expected to replace the true noncontrast images for radiation-dose reduction. This study assessed the feasibility of virtual noncontrast images for diagnosing SAH.

Compared to TSE sequence, the BLADE technique can reduce the respiratory motion, gastrointestinal peristalsis, and vascular pulsation artifacts, while decreasing the scanning time and improving the anatomic detail and image quality.