Optimization Of Contrast-Enhanced Digital Tomosynthesis

Optimization Of Contrast-Enhanced Digital Tomosynthesis-29
They found that CEDM had a sensitivity of 93% vs a sensitivity of 90% for FFDM with ultrasonography, as well as improved specificity (63% for CEDM vs 47% for FFDM with ultrasonography). Predominately, the skin is nonenhancing or shows a thin line of enhancement.In a comparison of CEDM with MRI, 2 studies have shown that CEDM is similar to MRI. Rarely, it shows artifactual thickening not seen on the standard 2-dimensional image.

They found that CEDM had a sensitivity of 93% vs a sensitivity of 90% for FFDM with ultrasonography, as well as improved specificity (63% for CEDM vs 47% for FFDM with ultrasonography). Predominately, the skin is nonenhancing or shows a thin line of enhancement.In a comparison of CEDM with MRI, 2 studies have shown that CEDM is similar to MRI. Rarely, it shows artifactual thickening not seen on the standard 2-dimensional image.

The differences in nipple enhancement between MRI and CEDM are likely secondary to a combination of the differing contrast agents used and the compression applied with CEDM.

As with typical FFDM, every effort should be made to place the nipple in profile.

Also similar to MRI, when breast cancer is present, neoangiogenesis results in an increased number of enhancing vessels supplying the affected breast.

These findings are typically seen in the upper outer quadrants.

When the nipple is not in profile (Figure 2A) the nipple may be mistaken for an enhancing mass within the anterior breast.

By comparison, an image showing the nipple in profile allows for better detection of subareolar masses and helps prevent the nipple from being mistaken for a mass (Figure 2B).

However, the digitally subtracted image is unlike those that mammographers are accustomed to interpreting and its use initially may be overwhelming.

With this paper, the authors aim to increase understanding of normal anatomic and non-anatomic structures encountered on subtracted images and increase awareness of commonly encountered artifacts.

Normal axillary and intramammary lymph nodes have characteristically benign appearances, including circumscribed margins; oval, round, or reniform shape; a fatty hilum; and proximity to a vessel.

Lymph nodes show various degrees of enhancement on CEDM images whereby the enhancement is not necessarily indicative of pathologic characteristics.

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