Studies in the diagnosis of breast disease (author's transl)]

The relative diagnostic accuracy of clinical examination, mammography, thermography and ultrasound was investigated in a comparative study. Mammography proved to be the most accurate diagnostic method, followed by clinical examination, thermography and ultrasound. Whereas in cases of advanced cancer (T2 to T4 tumour diameter greater than 2 cm) the correct diagnosis was made most reliably by clinical examination, mammography was superior to all other procedures in T1 tumours and in impalpable tumours. In our opinion thermography and ultrasound should be excluded for routine use or as a screening test because of the high false negative results. It is, however, noteworthy, that small intraparenchymal cysts can be detected and localized by ultrasound in a very high percentage of cases.     

Thermography.

As thermographic equipment is improved and as physicians gain experience in its use, thermography gradually is gaining importance as a diagnostic aid in a wide range of disease processes. The technic is finding increasing acceptance in diagnosis of breast disease particularly as an adjunct to mammography. The American Cancer Society and the National Cancer Institute are in the process of establishing 20 demonstration centers for breast cancer detection using thermography, mammography, and physical examinations. Although all of the centers are not at present fully staffed with personnel experienced in thermographic interpretation, the project promises to give a better basis for cost estimates for screening with the thermography as compared to present systems. The technologic knowledge exists for the development of improved scanning infrared cameras with magnetic tape storage and dynamic display. These systems will lend themselves to quantitative measurements and semiautomatic interpretation which can improve the accuracy and reduce the cost of mass screening for breast cancer. Although additional clinical research is necessary, thermography has numerous applications in a variety of disease states. In the future, total body thermography may well become an important part of medical screening examinations.     

Relevance of palpatory, mammographic and thermographic assessment criteria in benign and malignant structural changes in the female breast

The correlation between clinical findings, mammography and thermography on the one hand and histological structure of the breast on the other hand, was investigated in 133 women. Palpable changes in the breast parenchyma indicated excision biopsy in all cases. The following criteria were employed for palpatory assessment: size, differentiation, nodular mobility and consistency. For mammography, criteria such as calcification, opacity, contralateral comparison and skin thickening were used. For thermography, a modified "Gautherie score" was employed. All three palpatory parameters, however, do not provide reliable differentiation between benign and malignant tumours, since the palpatory findings in fibrocystic disease are similar to those in large malignant growths. Small malignant growths, in turn, may resemble benign tumours. Furthermore, the group of fibrocystic disease markedly reduces the specificity of the radiological findings. However, as aid to differential diagnosis it may be said that apart from the shape of the shadow, contralateral difference in appearance is more likely to occur with benign and malignant tumours than with fibrocystic disease. With regard to thermography a low score i.e. an unconspicuous picture of heat distribution is unlikely to signify a malignant growth. It is, however, impossible to distinguish between mastopathy and malignant tumour. Additional investigations i.e. mammography and thermography do not rule out the existence of a malignant growth.     

Changes in the breast in Hodgkin's and non-Hodgkin's lymphoma

The results of mammography, infrared thermography, cytology and histology are compared for 13 patients with secondary Hodgkin's disease and for 4 patients with primary and 9 with secondary Non-Hodgkin lymphoma. It was found, that an accurate diagnosis can be achieved only by cytology and histology     

远红外线热像图对乳腺疾病的诊断价值(附11 200例分析)

目的探讨远红外热线扫描对乳腺疾病的诊断价值。方法11 200例乳腺疾病及正常者进行远红外扫描,并由病理学检查证实。结果病理证实乳腺癌150例,其中134例被远红外热像图检测为阳性,诊断符合率89.3%。结论远红外热像对乳腺癌的普查、早期诊断及鉴别诊断有较高的临床应用价值。     

The enigma of the false-positive stress test

Survival statistics for breast cancer have been stalemated for 30 years, principally because cancer is not detected early enough. Breast examination by the patient is important, but we must not depend too heavily on this method. Physicians should examine periodically the breasts of all women over 35 years of age and supplement the examination with other methods of detection. Three ancillary methods are discussed: mammography, thermography and xeroradiography.     

How good is thermography in breast cancer screening?

With the present level of experience and with current equipment, thermography does not seem sufficiently reliable to substitute for either clinical examination or mammography in breast cancer detection. It is, however, of adjunctive value and can be used in frequent screening and in younger individuals. Women with positive thermograms should be followed more closely, both clinically and radiographically, than the average patient.     

乳腺病变动态增强MRI、乳腺摄影片、超声、病理对照研究

目的比较动态增强MRI、乳腺摄影片、超声对乳腺病变,尤其是乳腺癌的诊断价值。方法对30例乳腺病变的61个病灶的三种影像学检查手段与病理结果相对照,计算每种检查方法的灵敏度、特异度等指标并两两比较。结果超声、乳腺X线摄影、动态增强MRI对61个乳腺病灶的诊断灵敏度、特异度分别为:41.2%、84.6%,35.3%、87.2%,94.1%、94.9%;超声、乳腺X线摄影联合检查的灵敏度、特异度为47.6%、85.4%。动态增强MRI与乳腺摄影诊断正确率的差别有统计学意义(χ2=32.378,P=0.000);乳腺摄影和超声间的差别无统计学意义(χ2=0.569,P=0.451)。结论对乳腺病变的检查,动态增强MRI较X线摄影和超声的诊断效果更好。     

超声联合钼靶X线在乳腺癌中的诊断价值

目的探讨彩色多普勒超声（CDFI）联合钼靶X线对乳腺癌的诊断价值。方法回顾性分析166例乳腺肿瘤患者的CDFI与钼靶X线检查表现,并与手术或病理结果进行比较。结果 166例患者中121例病理证实乳腺癌。联合诊断的符合率与单独应用CDFI或钼靶X线相比,差异均有统计学意义（P〈0.05）。联合诊断乳腺癌的准确率为91.7%,尤其对于最大径〈1.0 cm的肿块,检出率较高。CDFI、钼靶X线诊断乳腺癌的准确率分别为80.2%、75.2%。结论 CDFI和钼靶X线检查各具优势,联合应用能明显提高乳腺癌的检出率。     

Neuromusculoskeletal thermography: a valuable diagnostic tool?

The use of neuromusculoskeletal thermography is rapidly increasing. Recent studies have begun to document the types of diagnostic and other clinically useful information which may be derived from the procedure. This paper provides a review and summary of current research and a comparison with myelography, computerized tomography, electromyography and clinical and surgical findings in cases of presumed musculoskeletal pain syndromes. The importance of diagnostic sensitivity, specificity, positive and negative predictive value, and accuracy (validity) are discussed. In general, the literature reports high sensitivity and negative predictive value, but lower specificity and positive predictive value. The implications of these findings are examined in regard to clinical case management, with emphasis on potential usefulness to chiropractors. Although thermography appears to be a promising diagnostic tool, there remain a number of threats to the scientific validity of current research which must be accounted for in future work.     

MRI、CT与乳腺X线钼靶摄影诊断乳腺疾病的价值比较

目的:探究MRI、CT与乳腺X线钼靶摄影三种检查方式对乳腺疾病的诊断价值,为临床治疗乳腺疾病提供理论参考。方法:选择2018年1月—2019年1月期间在我院接受治疗的96例乳腺疾病患者作为本次实验探究的研究对象,所有患者均进行MRI检查、CT扫描与乳腺X线钼靶摄影检查,比较三种检查方式对乳腺疾病的诊断准确率。结果:MRI的诊断准确率显著高于CT扫描和乳腺X线钼靶摄影,CT扫描的诊断准确率显著高于乳腺X线钼靶摄影,具有统计学意义(P<0.05)。结论:相对而言,乳腺X线钼靶摄影更适用于早期乳腺疾病的检查,MRI检查和CT扫描可有效提高乳腺疾病的诊断准确率,三种检查方法各有利弊,建议根据患者病情和个人情况,选择恰当的检查方法,或多种联合使用,能够有效提高患者的诊断准确率,对后期治疗方法的选择具有较高的参考意义,有利于提升预后效果。     

全数字化乳腺点压摄影诊断致密型乳腺中乳腺癌

目的 探讨数字化乳腺点压摄影对致密型乳腺的乳腺癌的诊断价值。 方法 对68例致密型乳腺的乳腺癌患者经全数字化乳腺X线检查常规检查(首尾位及内外斜位)后,对触诊异常区域加摄无放大点压摄影,分别分析常规摄影和点压摄影的影像表现并进行对比。 结果 点压摄影在肿块显示、毛刺显示方面明显优于常规摄影。两种方法对钙化的显示率无显著差别,但在显示钙化数量、大小、形态及密度等具体特征方面,压点摄影优于常规摄影。4例常规摄影显示乳腺结构扭曲的患者,点压摄影可见小肿块;5例常规摄影显示乳腺局灶性不对称患者,点压摄影均可见肿块。点压摄影的诊断准确率(86.76%)高于常规摄影(63.24%),漏诊及误诊率(4.41%)低于常规摄影(14.70%)。 结论 常规乳腺摄影结合点压摄影能够明显提高致密型乳腺的乳腺癌的诊断准确率。     

Thermography in diagnosis of radiculopathies

Infrared imaging (thermography) has developed rapidly over the past 10-15 years as a diagnostic imaging procedure. Despite scientific validation and proven use in the clinical setting, neuromuscular thermography has met with much criticism and skepticism. The emotional and political controversy surrounding thermography has distracted the medical community to such an extent that the real issue of utmost importance to the practicing physician is often ignored. The basic scientific foundation of medicine should preclude the prejudicial influence of emotion, politics, and anecdotes. Scientific investigations, for more than 2 decades now, have demonstrated that neuromuscular thermography is of proven value in the clinical evaluation of various pain disorders and neuromuscular conditions, including radicular pathology.     

乳腺钼靶X线摄影技术的探讨

目的 探讨乳腺钼靶X线摄影技术,提高乳腺摄影片的质量及其在临床诊断中的应用.方法 对500例乳腺摄影片患者的年龄、乳腺类型、投照体位进行分类,总结乳腺钼靶X线摄影技术的要点及质量控制.结果 500例乳腺X线检查,95%乳腺片满足临床诊断要求.乳腺分类中致密型86例（17.2%）、腺体型217（43.4%）、退化型147（29.4%）、萎缩型50（10%）.乳腺分型与各年龄段重叠较多.双侧对照,常规内外斜位及轴位基本满足诊断要求.结论 乳腺钼靶片的成像质量对临床正确诊断的先决条件,充分的检查前准备,合适的检查体位及摄影参数的合理选择是取得高质量乳腺钼靶片的关键.     

Breast cancer screening and problem solving using mammography, ultrasound, and magnetic resonance imaging

Although mammography is the mainstay of early breast cancer detection, it has known limitations, particularly in women with dense breasts. As a result, additional imaging modalities, including ultrasound and contrast-enhanced magnetic resonance imaging, are also being used to supplement mammography in the early detection of occult breast cancer. This article reviews the indications and efficacy of mammography, ultrasound, and magnetic resonance imaging as both screening and diagnostic tools.     

Imaging of the breast

A multitude of techniques for imaging and evaluating the breast have been described. Based upon current evidence, thermography does not appear to have any established clinical indications. Computed tomography, ultrasonography, lightscanning, and NMR may be useful as adjuncts to mammography, and further research seems warranted. Mammography remains the "gold standard" in breast imaging, however. Its ability to detect clinically occult disease makes it the superior imaging technique in the breast, and the only technique indicated for screening. In light of the information presented in this article, it is hoped that the trend away from mammography in favor of so-called "noninvasive" breast imaging techniques will be reversed until such time that the efficacy of these other modalities has been proven. A proper process for the evaluation and clinical testing of the newer breast imaging modalities has been defined. Using this as a guideline, it is hoped that the indiscriminate clinical use of unproven techniques will be avoided.     

早期乳腺癌综合检测价值

目的：探讨早期乳腺癌综合检测临床价值。材料与方法：选择临床有或无症状、未扪及包块或包块小于2cm，怀疑为乳腺癌患者，行冷光透照、液晶热图及X线钼靶检查，至少两项检查高度怀疑为乳腺癌者，均经外科手术治疗并做病理学检查。结果：43例患者中，38例术后病理证实为乳腺癌，误诊5例，其中3例为乳腺纤维瘤，2例为炎症，准确率为88．4％。结论：综合检测提高了早期乳腺癌的检出率。     

乳腺X线摄影及彩超对结构扭曲病变的诊断效能比较

目的研究乳腺X线摄影（全数字化乳腺摄影与数字乳腺断层摄影）及彩超对于结构扭曲良恶性病变诊断效能对比研究及结构扭曲在X线征象的分析方法。方法收集本院2013年6月~2018年12月就诊的51例乳腺疾病患者,年龄20~70岁（44.84±8.738岁）,均接受全数字化乳腺摄影、数字乳腺断层摄影及彩超检查且发现单纯结构扭曲征象,同时具有病理结果,根据乳腺影像报告和数据系统进行阅片诊断,比较3种影像学方法的诊断效能及结构扭曲的征象分析。结果Fisher精确算法分析显示,结构扭曲X线征象（中心密度、病灶边缘情况、病变区周围腺体结构）均在良恶性鉴别存在显著性差异（P<0.05）。ROC曲线分析发现,3种检查方式曲线下面积均大于0.5,均具有乳腺疾病诊断价值。3种检查方法,数字乳腺断层摄影敏感度 （ 67.5%）大于全数字化乳腺摄影（ 62.2%）及彩超（61.9%）,特异性数字乳腺断层摄影均高于其他两者。结论数字乳腺断层摄影相对于全数字化乳腺摄影、彩超能更好地观察结构扭曲病变,提高诊断效能。      

高频超声和X线钼靶在乳腺癌诊断中的对照研究

目的：探讨二维与彩色多普勒超声检查以及X线钼靶检查联合应用对乳腺癌诊断的实用价值。方法：136例女性乳腺癌患者均行手术并经病理学证实，采用高频二维与彩色多普勒超声检查和X线钼靶检查对乳腺肿块进行诊断与鉴别诊断。结果：彩超对乳腺癌的敏感性为87.5%，X线钼靶对乳腺癌的敏感性为73.5%，超声与X线钼靶联合应用的敏感性为92.6％。结论：利用高频超声与X线钼靶检查的互补性可显著提高乳腺癌的诊断率。